Abstract
The present study examined temporal trends and geographic clustering of amyotrophic
lateral sclerosis (ALS) mortality in Japan, during 1995–2004, using vital statistics
based on death certificates. ALS was usually diagnosed by neurologists according to
clinical guidelines that complied with the El Escorial Criteria. The underlying cause
of death for ALS was coded as G12.2A. Regression analysis was used to examine temporal
trends. Spatial scan statistic was used to detect any area of elevated risk as a cluster.
A total of 12,173 (6864 male and 5309 female) ALS deaths were reported. Annual crude
mortality rate per 100,000 population was 1.07 (1.26 for males and 0.89 for females)
in 2004. Although the overall temporal trend was stable, the trend increased in the
70+years age group (p for trend, <0.001 in males and <0.05 in females), while it declined in the under 70 years age group (p for trend, <0.01 for both sexes). Male preponderance and M/F ratio remained nearly constant over
time. Three clusters were detected: two (p<0.005 in males and p<0.05 in females) in northeast and one (p<0.05 in males) in west-central Japan. Further research is needed to clarify contributing
factors for the observed trends and clusters in ALS mortality.
Keywords
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Article info
Publication history
Published online: September 01, 2010
Accepted:
August 5,
2010
Received in revised form:
August 5,
2010
Received:
March 29,
2010
Identification
Copyright
© 2010 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
