Climbing ALS death rates seen in Finland, not due to aging alone: Study
Similar increases seen in other Nordic countries, but not globally
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- ALS death rates in Finland nearly doubled between 1987 and 2022, especially in older adults, a study found.
- Researchers noted that this trend has not been observed in other countries, such as the U.S. and Japan.
- Improved diagnostics or increased risk factor exposure may explain the rise; further research is needed, the scientists say.
Deaths from amyotrophic lateral sclerosis (ALS) have nearly doubled in Finland over the past three decades, with increases in mortality seen especially among older adults, according to a new study.
The reasons for this trend aren’t clear, however, and the researchers noted that similar increases have not been reported globally, despite also being seen in other Nordic countries.
The research team — a trio from Tampere University — examined ALS-related deaths in the European nation between 1987 and 2022 and found they became more common for both men and women and across several age groups.
Because the results were adjusted for age, these differences are “not attributable to aging of the population,” the researchers wrote. Instead, the team suggested that the identification of more new cases due to better diagnosis tools and increased exposure to ALS risk factors may explain the findings.
The study, “Mortality From Amyotrophic Lateral Sclerosis in Finland 1987-2022,” was published in the European Journal of Neurology.
Many Nordic countries have seen ALS mortality rise in recent decades, but this trend has not been observed across all age groups. Further, an increase in ALS death rates has not been seen in other countries such as the U.S., the researchers noted.
“In addition, mortality from ALS decreased in the population younger than 70 years of age in Japan during 1995-2004,” the team wrote.
ALS death rates nearly doubled in Finland over 3 decades
In this study, the trio of scientists set out to assess if ALS mortality in Finland saw a similar increase to other Scandinavian countries. To do this, the team used the Finnish Death Certificate Register, which includes the number of deaths from ALS between 1987 and 2022 by year, sex, and age group.
This was one of the study’s strengths, the scientists reported, noting that “the quality and reliability of Finland’s vital statistics are among the best worldwide.”
The results showed that, after statistically controlling for age, 2.24 people per 100,000 in Finland died of ALS in 1987. That number rose to 4.21 people per 100,000 by 2022. This corresponded to an average increase of 1.7% each year.
Both men and women saw relatively similar increases in ALS mortality over the years. However, while the age-controlled ALS mortality rate for men increased approximately steadily by 1.2% annually, the rate for women varied more. For example, between 1987 and 1997, there was a 5.5% increase each year for women, whereas after 1997, the increase was about 1% each year, the data showed.
Additionally, the team found a statistically significant difference in mortality rates by age. Individuals younger than 50 had relatively steady death rates throughout the examined period. People in their 50s and 60s saw some annual increases — of about 1% per year — while those 70 and older had the largest change, with age-adjusted death rates increasing 2.4% each year.
Researchers unsure how to explain these trends
These trends mirror those of other countries in Scandinavia. However, the researchers are unsure how to explain them.
Certain genetic mutations associated with ALS are more common in Finland than elsewhere. But that’s probably not the only answer, the researchers say.
“These enrichments are likely key factors explaining the high incidence and mortality of ALS in Finland. It is unlikely, however, to explain the increasing trend in mortality,” the team wrote.
Possible factors behind the increased mortality can include improved diagnostics or increased exposure to risk factors.
Instead, the scientists suggested that the increasing death rate may reflect an increasing incidence — in other words, more new cases — of ALS among the population.
“Possible factors behind the increased mortality can include improved diagnostics or increased exposure to risk factors,” the team wrote, pointing to an increase in obesity levels and a decrease in physical activity over the years.
Still, the researchers noted that many environments risk factors, such as smoking and exposure to pesticides, have decreased in recent decades. As that would supposedly lead to fewer diagnoses and deaths from the disease, more research will be needed to fully elucidate the factors behind the increased mortality rates, per the team.
“Further research on possible reasons is needed,” the researchers wrote.
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