Insight into Elderly ALS Patients in the Emilia Romagna Region: Epidemiological and Clinical Features of Late-Onset ALS in a Prospective, Population-Based Study.

Autor: Gianferrari G; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy., Martinelli I; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy.; Clinical and Experimental Medicine Ph.D. Program, University of Modena and Reggio Emilia, 41125 Modena, Italy., Simonini C; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy., Zucchi E; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy.; Neuroscience Ph.D. Program, University of Modena and Reggio Emilia, 41125 Modena, Italy., Fini N; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy., Caputo M; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy., Ghezzi A; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy., Gessani A; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy., Canali E; Department of Neurology, IRCCS Arcispedale Santa Maria Nuova, 42123 Reggio Emilia, Italy., Casmiro M; Department of Neurology, Faenza and Ravenna Hospital, 48100 Ravenna, Italy., De Massis P; Department of Neurology, Imola Hospital, 40026 Bologna, Italy., Curro' Dossi M; Department of Neurology, Infermi Hospital, 48018 Rimini, Italy., De Pasqua S; Department of Neurology, Carpi Hospital, 41012 Modena, Italy., Liguori R; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy.; IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40126 Bologna, Italy., Longoni M; Department of Neurology, Infermi Hospital, 48018 Rimini, Italy.; Department of Neurology, Bufalini Hospital, 47521 Cesena, Italy., Medici D; Department of Neurology, Fidenza Hospital, 43036 Parma, Italy., Morresi S; Department of Neurology, Bufalini Hospital, 47521 Cesena, Italy., Patuelli A; Department of Neurology, Forlì Hospital, 47121 Forlì, Italy., Pugliatti M; Department of Neurosciences, University of Ferrara, 44121 Ferrara, Italy.; Department of Neurology, St. Anna Hospital, 44124 Ferrara, Italy., Santangelo M; Department of Neurology, Carpi Hospital, 41012 Modena, Italy., Sette E; Department of Neurology, St. Anna Hospital, 44124 Ferrara, Italy., Stragliati F; Department of General and Specialized Medicine, University Hospital of Parma, 43126 Parma, Italy., Terlizzi E; Department of Neurology, G. Da Saliceto Hospital, 29121 Piacenza, Italy., Vacchiano V; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy.; IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40126 Bologna, Italy., Zinno L; Department of General and Specialized Medicine, University Hospital of Parma, 43126 Parma, Italy., Ferro S; Department of Hospital Services, Emilia Romagna Regional Health Authority, 40127 Bologna, Italy., Amedei A; Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy., Filippini T; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.; Research Centre in Environmental, Genetic and Nutritional Epidemiology-CREAGEN, University of Modena and Reggio Emilia, 41125 Modena, Italy.; School of Public Health, University of California Berkeley, Berkeley, CA 94704, USA., Vinceti M; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.; Research Centre in Environmental, Genetic and Nutritional Epidemiology-CREAGEN, University of Modena and Reggio Emilia, 41125 Modena, Italy.; Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA 02118, USA., Errals Group, Mandrioli J; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.; Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2023 Apr 03; Vol. 13 (4). Date of Electronic Publication: 2023 Apr 03.
DOI: 10.3390/life13040942
Abstrakt: Few studies have focused on elderly (>80 years) amyotrophic lateral sclerosis (ALS) patients, who represent a fragile subgroup generally not included in clinical trials and often neglected because they are more difficult to diagnose and manage. We analyzed the clinical and genetic features of very late-onset ALS patients through a prospective, population-based study in the Emilia Romagna Region of Italy. From 2009 to 2019, 222 (13.76%) out of 1613 patients in incident cases were over 80 years old at diagnosis, with a female predominance (F:M = 1.18). Elderly ALS patients represented 12.02% of patients before 2015 and 15.91% from 2015 onwards ( p = 0.024). This group presented with bulbar onset in 38.29% of cases and had worse clinical conditions at diagnosis compared to younger patients, with a lower average BMI (23.12 vs. 24.57 Kg/m 2 ), a higher progression rate (1.43 vs. 0.95 points/month), and a shorter length of survival (a median of 20.77 vs. 36 months). For this subgroup, genetic analyses have seldom been carried out (25% vs. 39.11%) and are generally negative. Finally, elderly patients underwent less frequent nutritional- and respiratory-supporting procedures, and multidisciplinary teams were less involved at follow-up, except for specialist palliative care. The genotypic and phenotypic features of elderly ALS patients could help identify the different environmental and genetic risk factors that determine the age at which disease onset occurs. Since multidisciplinary management can improve a patient's prognosis, it should be more extensively applied to this fragile group of patients.
Databáze: MEDLINE
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