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TOPLINE
Higher physical activity levels, both self-reported and device-measured, were associated with a lower risk for amyotrophic lateral sclerosis (ALS), a prospective UK study showed.
METHODOLOGY
- Researchers analyzed data from 384,836 UK Biobank participants (median age at recruitment, 57 years; 52.1% women).
- Physical activity was evaluated in all participants using the short International Physical Activity Questionnaire (IPAQ) at baseline and in a subset of participants (n = 96,570) using a wrist-worn accelerometer for 7 days (2013-2015), measuring overall acceleration and time spent in sedentary, light, and moderate-to-vigorous activity. Based on IPAQ criteria, total physical activity was classified as low, moderate, and high.
- The primary outcome was incident ALS diagnosis, with cases identified through linked hospital or death records across Wales, England, and Scotland.
- The analysis was adjusted for sex, smoking status, alcohol consumption, age at education completion, employment status, socioeconomic deprivation, and BMI. The median follow-up duration was 14 years.
- Subgroup analyses examined associations in 535 C9ORF72 hexanucleotide repeat expansion carriers and 46,872 individuals with C-allele homozygosity at rs12608932 in UNC13A — groups at an increased genetic risk for ALS.
TAKEAWAY
- During follow-up, 541 incident ALS cases were observed in the questionnaire cohort and 98 cases in the accelerometry cohort. Compared with participants in the low IPAQ category, those in the high IPAQ category had a 23% lower risk for ALS (hazard ratio [HR], 0.77; 95% CI, 0.61-0.96) and those in the moderate category had a 26% lower risk (HR, 0.74; 95% CI, 0.59-0.94).
- Each 1-SD (8.24 mg) increase in the overall device-measured physical activity was associated with a 25% lower risk for ALS (HR, 0.75; 95% CI, 0.58-0.97), with a linear dose-response relationship.
- In the questionnaire cohort, moderate physical activity in the second (Q2) and third (Q3) quartiles, compared with the first quartile, was associated with a lower risk for ALS (Q2: HR, 0.73; 95% CI, 0.58-0.92; Q3: HR, 0.77; 95% CI, 0.60-0.98), whereas walking or vigorous activity alone showed no significant associations.
- Among individuals with C-allele homozygosity at rs12608932 in UNC13A, each 1-SD increase in accelerometer-measured activity was associated with a lower risk for ALS (HR, 0.46; 95% CI, 0.25-0.88; 17 events), but self-reported activity was not.
IN PRACTICE
"[T]his result does not support the general avoidance of or reduction in physical activity, especially at levels relevant to the general population, in high ALS risk populations," the authors wrote.
SOURCE
The study was led by Jiali Gao, University of Oxford, Oxford, England. It was published online on October 13 in the Journal of Neurology, Neurosurgery & Psychiatry.
LIMITATIONS
The study was limited by one-time measurement of physical activity, a relatively healthy and predominantly White and middle-aged sample, lack of data on ALS phenotype and severity, and possible residual confounding and reverse causation. Additionally, diagnoses recorded in hospital and death certificate data may have been made after symptom onset.
DISCLOSURES
Funding information for the study was not provided, although several investigators reported being supported by various sources. They reported no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
