Download PDF
Open Access
CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(10): s00451812029
DOI: 10.1055/s-0045-1812029
Original Article

Impact of weight loss and disease progression on survival in ALS: insights from a multidisciplinary care center

Authors

  • Mário Emílio Teixeira Dourado Junior 

    1   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Departamento de Medicina Integrada, Natal RN, Brazil.

  • Laura Carvalheira Dourado 

    2   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição, Natal RN, Brazil.

  • Glauciane Costa Santana 

    3   Universidade Federal do Rio Grande do Norte, Hospital Universitário Onofre Lopes, Natal RN, Brazil.

  • Sancha Helena de Lima Vale 

    4   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Departamento de Nutrição, Natal RN, Brazil.

  • Lucia Leite-Lais 

    4   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Departamento de Nutrição, Natal RN, Brazil.

Funding This research was conducted with the internal support of UFRN and HUOL. No external funding or grants were received for this study.
Further Information
Also available at
  Permissions and Reprints

Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a multifaceted neurodegenerative disorder with a poor prognosis. Weight loss and malnutrition emerge as significant clinical features during disease progression.

Objective

To explore how demographic and clinical characteristics relate to survival in ALS patients, emphasizing the role of weight loss percentage at the time of diagnosis.

Methods

We conducted a retrospective study that used the database of a multidisciplinary ALS care center in the city of Natal, Brazil.

Results

A total of 132 patients were included in the study. The mean age of the participants at symptom onset was of 56.9 years, and most of them were male (59.8%). Older age, bulbar onset, and faster disease progression were associated with weight loss ≥ 10% at diagnosis. Among 132 patients, 72% experienced death or tracheostomy, with a median survival of 34 months. Survival was notably reduced in patients aged ≥ 60 years, those with significant weight loss, rapid disease progression, or those submitted to gastrostomy. Weight loss and the rate of disease progression were the strongest predictors of reduced survival. Potential factors relating gastrostomy with reduced survival are discussed.

Conclusion

The present study highlights the critical impact of weight loss and disease progression on survival in ALS patients, emphasizing the importance of early nutritional and clinical interventions. These findings underscore the need for comprehensive, multidisciplinary care strategies to address key prognostic factors and improve outcomes in ALS patients.

Keywords

Amyotrophic Lateral Sclerosis - Weight Loss - Disease Progression - Nutritional Status - Survival Analysis

Authors' Contributions

Conceptualization: METDJ; Data curation: METDJ, GCS, LLL; Formal analysis: METDJ, LCD, LLL; Methodology: METDJ, SHLV, LLL; Supervision: GCS, LLL; Writing – original draft: LCD, LLL; Writing – review & editing: METDJ, LCD, GCS, SHLV, LLL.


Data Availability Statement

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.


Editor-in-Chief: Ayrton Roberto Massaro (https://orcid.org/0000-0002-0487-5299).


Associate Editor: Wilson Marques Jr. (https://orcid.org/0000-0002-4589-2749).




Publication History

Received: 22 January 2025

Accepted: 27 July 2025

Article published online:
15 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Mário Emílio Teixeira Dourado Junior, Laura Carvalheira Dourado, Glauciane Costa Santana, Sancha Helena de Lima Vale, Lucia Leite-Lais. Impact of weight loss and disease progression on survival in ALS: insights from a multidisciplinary care center. Arq Neuropsiquiatr 2025; 83: s00451812029.
DOI: 10.1055/s-0045-1812029