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
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
