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Amyotrophic lateral sclerosis (ALS) among immigrant groups and Swedish-born individuals : a cohort study of all adults 18 years of age and older in Sweden

Wändell, Per LU ; Fredrikson, Sten ; Carlsson, Axel C. ; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2022) In Journal of Neurology 269(4). p.1989-1995
Abstract

Background: There is a lack of studies of amyotrophic lateral sclerosis (ALS) in immigrants. Objective: The objective is to study the association between country of birth and incident ALS in first-generation immigrants versus Swedish-born individuals, and in second-generation immigrants versus native Swedes. Methods: Study populations included all adults aged 18 years and older in Sweden, in the first-generation study 6,128,698 individuals (2,975,141 men, 3,153,557 women) with 5,344 ALS cases (3017 men, 2327 women), and in the second-generation study 4,588,845 individuals (2,346,855 men and 2,241,990 women) with 3,420 cases (2027 men and 1393 women). ALS was defined as having at least one registered diagnosis of ALS in the National... (More)

Background: There is a lack of studies of amyotrophic lateral sclerosis (ALS) in immigrants. Objective: The objective is to study the association between country of birth and incident ALS in first-generation immigrants versus Swedish-born individuals, and in second-generation immigrants versus native Swedes. Methods: Study populations included all adults aged 18 years and older in Sweden, in the first-generation study 6,128,698 individuals (2,975,141 men, 3,153,557 women) with 5,344 ALS cases (3017 men, 2327 women), and in the second-generation study 4,588,845 individuals (2,346,855 men and 2,241,990 women) with 3,420 cases (2027 men and 1393 women). ALS was defined as having at least one registered diagnosis of ALS in the National Patient Register 1998–2017. The incidence of ALS in different first-generation immigrant groups versus Swedish-born individuals was assessed by Cox regression, expressed as hazard ratios (HRs) with 95% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Results: After adjusting for potential confounders, the HRs were lower in foreign-born men, 0.71 (95% CI 0.63–0.81), and women, 0.80 (95% CI 0.70–0.92). The ALS risk was lower among men and women from most Western countries (Europe outside Nordic countries, and North America), and from other regions of the world (Africa, Asia, and Latin America). Among men and women with foreign-born parents, the risk of ALS did not differ significantly from native Swedes. Significance: In general, the risk of ALS was lower in first-generation men and women but did not differ in second-generation individuals.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ALS, Gender, Immigrants, Neighborhood, Socioeconomic status
in
Journal of Neurology
volume
269
issue
4
pages
1989 - 1995
publisher
Springer
external identifiers
  • scopus:85113303156
  • pmid:34427755
ISSN
0340-5354
DOI
10.1007/s00415-021-10765-6
language
English
LU publication?
yes
id
ca85d8b3-cf10-48bb-a8a0-cfee828af75c
date added to LUP
2021-12-15 15:15:49
date last changed
2024-06-17 01:35:31
@article{ca85d8b3-cf10-48bb-a8a0-cfee828af75c,
  abstract     = {{<p>Background: There is a lack of studies of amyotrophic lateral sclerosis (ALS) in immigrants. Objective: The objective is to study the association between country of birth and incident ALS in first-generation immigrants versus Swedish-born individuals, and in second-generation immigrants versus native Swedes. Methods: Study populations included all adults aged 18 years and older in Sweden, in the first-generation study 6,128,698 individuals (2,975,141 men, 3,153,557 women) with 5,344 ALS cases (3017 men, 2327 women), and in the second-generation study 4,588,845 individuals (2,346,855 men and 2,241,990 women) with 3,420 cases (2027 men and 1393 women). ALS was defined as having at least one registered diagnosis of ALS in the National Patient Register 1998–2017. The incidence of ALS in different first-generation immigrant groups versus Swedish-born individuals was assessed by Cox regression, expressed as hazard ratios (HRs) with 95% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Results: After adjusting for potential confounders, the HRs were lower in foreign-born men, 0.71 (95% CI 0.63–0.81), and women, 0.80 (95% CI 0.70–0.92). The ALS risk was lower among men and women from most Western countries (Europe outside Nordic countries, and North America), and from other regions of the world (Africa, Asia, and Latin America). Among men and women with foreign-born parents, the risk of ALS did not differ significantly from native Swedes. Significance: In general, the risk of ALS was lower in first-generation men and women but did not differ in second-generation individuals.</p>}},
  author       = {{Wändell, Per and Fredrikson, Sten and Carlsson, Axel C. and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0340-5354}},
  keywords     = {{ALS; Gender; Immigrants; Neighborhood; Socioeconomic status}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1989--1995}},
  publisher    = {{Springer}},
  series       = {{Journal of Neurology}},
  title        = {{Amyotrophic lateral sclerosis (ALS) among immigrant groups and Swedish-born individuals : a cohort study of all adults 18 years of age and older in Sweden}},
  url          = {{http://dx.doi.org/10.1007/s00415-021-10765-6}},
  doi          = {{10.1007/s00415-021-10765-6}},
  volume       = {{269}},
  year         = {{2022}},
}