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Age-period-cohort analysis of trends in amyotrophic lateral sclerosis incidence

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Abstract

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease with an unknown cause. Studies have reported that the incidence rate of ALS might be changing. As ALS is an age related disease, crude incidence could increase as population structure changes and overall life expectancy improves. Age-period-cohort (APC) models are frequently used to investigate trends in demographic rates such as incidence. Age-specific incidence rate for ALS from 1996 to 2014 were taken from a population-based ALS register in Ireland. To circumvent the well-known identifiability issue in APC models, we apply the method of Partial Least Squares Regression to separate the effects of Age, Period and Cohort on ALS incidence over time. This APC analysis shows no cohort effect and the initial signs of a period effect; increasing incidence of ALS in the most recently diagnosed group. As further years of data accrue to the Irish register it will become clear if this effect emerges as a strong trend in the incidence of ALS in Ireland and replication of these analyses in other populations will show if our findings on temporal patterns in ALS incidence are shared elsewhere.

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Acknowledgments

This work was funded by a Health Research Board Interdisciplinary Capacity Enhancement Award, Grant Number ICE/2012/6.

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Authors and Affiliations

  1. Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland

    Katy Tobin, James Rooney, Mark Heverin, Alice Vajda & Orla Hardiman

  2. Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, Ireland

    Katy Tobin

  3. Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK

    Mark S. Gilthorpe

  4. School of Nursing and Health Sciences, Dublin City University, Dublin 9, Ireland

    Anthony Staines

Authors
  1. Katy Tobin
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  2. Mark S. Gilthorpe
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  3. James Rooney
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  4. Mark Heverin
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  5. Alice Vajda
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  6. Anthony Staines
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  7. Orla Hardiman
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Corresponding author

Correspondence to Katy Tobin.

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Ethical approval

Ethical approval for this study was granted by Beaumont Hospital Ethics (Medical Research) Committee.

Conflicts of interest

Both Dr. Katy Tobin and Dr. James Rooney were funded under separate Grants from the Health Research Board during the conduct of the study. Prof. Orla Hardiman has received speaking honoraria from Janssen Cilag, Biogen Idec, Sanofi Aventis, Novartis and Merck-Serono. She has been a member of advisory panels for Biogen Idec, Allergen, Ono Pharmaceuticals, Novartis, Cytokinetics and Sanofi Aventis. She serves as Editor-in-Chief of Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Funding is from Health Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. 259867, ALSA (the ALS Association), HRB (the Health Research Board, Grant H01300), Joint Programme in Neurodegeneration (JPND), and Research Motor Neuron (previously named Motor Neuron Disease Research Foundation). All other authors have no conflicts of interest to declare.

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Tobin, K., Gilthorpe, M.S., Rooney, J. et al. Age-period-cohort analysis of trends in amyotrophic lateral sclerosis incidence. J Neurol 263, 1919–1926 (2016). https://doi.org/10.1007/s00415-016-8215-z

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  • DOI: https://doi.org/10.1007/s00415-016-8215-z

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