AMYOTROPHIC-LATERAL-SCLEROSIS MORTALITY IN ITALY, 1958 TO 1987 - A CROSS-SECTIONAL AND COHORT STUDY

We analyzed the mortality rates of amyotrophic lateral sclerosis (ALS) in Italy from 1958 to 1987. The overall mean annual mortality rate, a djusted to the 1981 Italian population, was 0.68/100,000 (95% confiden ce interval, 0.64 to 0.72); 0.86 for men; and 0.62 for women. During t hat period, mortality increased for both sexes: from 1958/1962 to 1983 /1987, mortality increased by 60% for women and 24% for men. The slope for women was 0.07, and for men, 0.02. Moreover, the mortality rate i ncreased in older age groups and was stable for subjects under 45 year s old. There was no clear birth-cohort effect, but in any cohort the a ge-specific mortality rate increased with advancing age, with no decli ne for the oldest age. Based on these data, the increase of ALS mortal ity rates is probably due to the effect of changing methodologic and d emographic variables and the decrease of mortality of some competing d iseases, rather than a real rise of the risk in the whole population o r in specific birth cohorts.