Physical Activity and early onset amyotrophic lateral sclerosis (ALS), Data from the National ALS Registry: 2010 – 2018 (777)

Objective: To examine the association between physical activity and early onset ALS, defined as a diagnosis before age 60, among patients enrolled in the Registry. Physical activity was defined as engaging in vigorous physical activity for at least 10 minutes that caused heavy sweating or large increases in breathing or heart rate. Background: The National ALS Registry (Registry) collects physical activity (PA) data from persons with ALS. These data are collected from patients who voluntarily enroll and complete online surveys. Design/Methods: A retrospective study was conducted of 5,463 ALS patients with an exercise history and 956 ALS patients who never exercised over the course of their lifetime. Patient characteristics were collected for the following areas: demographic characteristics among US adults with ALS, exercise status over their lifetime, mean workout times per week, sex, initial onset of weakness (limb, bulbar, and global), mean change of ALS functional rating scale (ALSFRS) per year, and body mass index (BMI). Results: Patients who exercised were statistically significantly more likely to be diagnosed with ALS before age 60 compared to patients who never exercised even after controlling for confounders. After stratifying exercise into quartiles, those who exercised more than 5 times per week between ages 15 and 24, were more than twice as likely to be diagnosed before age 60 compared to those who exercised less than 3 times per week during the same ages. Males, on average, exercised more per week than females. In addition, those who never exercised had a greater mean decline in ALSFRS per year than those who ever exercised. In the multivariate analysis, those with physically active occupations, those with bulbar or global initial onset, and a BMI over 25 at age 40 were all statistically significantly more likely to be diagnosed with ALS before age 60. Conclusions: Patients who exercised, especially those who exercised more than 5 times per week when they were young, were significantly more likely to be diagnosed before age 60 compared to those who never exercised. More research is needed to determine the relationship between physical activity 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. Horton has nothing to disclose.