Gender, reproductive history, and early onset amyotrophic lateral sclerosis (ALS), Data from the National ALS Registry: 2010 – 2018 (1138)

Objective: To examine the association between gender and reproductive history, women only, and early onset ALS, defined as a diagnosis before age 60, among patients enrolled in the Registry.

Background: Amyotrophic lateral sclerosis (ALS) is a neurological disease of largely unknown etiology with no cure. The National ALS Registry (Registry) collects demographic data from patients as well as reproductive history data from females with ALS. These data are collected from patients who voluntarily enroll and complete online surveys.

Design/Methods: A retrospective study was conducted of 4,688 male ALS patients and 3,206 female ALS patients. Patient characteristics were collected for the following areas: demographic characteristics among US adults with ALS, race, body mass index (BMI), and familial ALS, and a subset of the data looking at female reproductive history data including age at menopause, ever pregnant, and age at first pregnancy.

Results: Women were more likely to be diagnosed after age 60 (p<0.0001), have an ideal BMI, less than 25 kg/m^2′, at age 40 (p<0.0001), and have familial ALS (p=0.0002) compared to men in the study. When compared to only women with ALS diagnosis after age 60, women diagnosed before age 60 were more likely to: have limb onset, not have bulbar onset, have had their first menstrual cycle before age 12, and never have become pregnant. In the multivariate analysis with women only, those who entered menopause before age 50 were statistically more likely to be diagnosed with ALS before age 60 compared to women who entered menopause at or after age 50, after controlling for confounders (race, ever pregnant, age at first pregnancy and BMI at age 40).

Conclusions: Women who entered menopause before age 50 were significantly more likely to be diagnosed with ALS before age 60 compared to those who entered menopause after age 50. More research is needed to determine the relationship between female reproductive history and early onset ALS.

Disclosure: Dr. Raymond MPH has nothing to disclose. Dr. Mehta has nothing to disclose. Dr. Larson has nothing to disclose. Dr. Pioro has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Avanir Pharmaceuticals, Cytokinetics, MT Pharma America, Biohaven Pharmaceuticals, ITF Pharma, and Otsuka America Pharmaceutical. Dr. Pioro has received research support from NIH/CDC, and ALS Association. Dr. Horton has nothing to disclose.