Background: Globally, the annual incidence and prevalence of amyotrophic lateral sclerosis (ALS) are estimated at 1.9 and 4.5 per 100,000 population, respectively. This study is aimed at describing the epidemiology of ALS in Israel in a real-world setting. Methods: A retrospective study was performed using the databases of Maccabi Healthcare Services (MHS), a 2-million-member health maintenance organization in Israel. The study included all MHS adults diagnosed with ALS between 1997 and 2013. In 2013, characteristics of ALS patients were compared to those of age-sex-matched patients without ALS. Survival after ALS diagnosis was assessed until death and until tracheostomy or death (follow-up through 2014). Results: In 2013 (n = 158), the prevalence of ALS was 8.1 per 100,000 population in MHS. In 1997-2013, a total of 375 ALS patients were diagnosed, corresponding to an average annual incidence of 1.8 per 100,000 population in MHS. The median survival from diagnosis to death was 3.5 years (95% CI 2.9-4.1), with approximately 28% surviving at least 10 years. Median tracheostomy-free survival was 2.5 years (95% CI 2.1-2.9). Conclusions: Results suggest that there is a relatively high prevalence of ALS in Israel. Further research is needed to investigate factors that may contribute to the survival of patients with ALS in Israel.

1.
Chio A, Logroscino G, Hardiman O, Swingler R, Mitchell D, Beghi E, Traynor BG: Prognostic factors in ALS: a critical review. Amyotroph Lateral Scler 2009;10:310-323.
2.
Chio A, Logroscino G, Traynor BJ, Collins J, Simeone JC, Goldstein LA, White LA: Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology 2013;41:118-130.
3.
Marin B, Boumédiene F, Logroscino G, Couratier P, Babron MC, Leutenegger AL, Copetti M, Preux PM, Beghi E: Variation in worldwide incidence of amyotrophic lateral sclerosis: a meta-analysis. Int J Epidemiol 2016;pii:dyw061.
4.
Cohen R, Rabin H: Membership in Sick Funds 2013. Jerusalem, National Insurance Institute of Israel, 2014.
5.
Kioumourtzoglou MA, Seals RM, Himmerslev L, Gredal O, Hansen J, Weisskopf MG: Comparison of diagnoses of amyotrophic lateral sclerosis by use of death certificates and hospital discharge data in the Danish population. Amyotroph Lateral Scler Frontotemporal Degener 2015;16:224-229.
6.
Kioumourtzoglou MA, Rotem RS, Seals RM, Gredal O, Hansen J, Weisskopf MG: Diabetes mellitus, obesity, and diagnosis of amyotrophic lateral sclerosis: a population-based study. JAMA Neurol 2015;71:905-911.
7.
Brooks BR, Miller RG, Swash M, Munsat TL: El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord 2000;1:293-299.
8.
Benatar M, Wuu J, Usher S, Ward K: Preparing for a U.S. national ALS registry: lessons from a pilot project in the state of Georgia. Amyotroph Lateral Scler 2011;12:130-135.
9.
Israel Central Bureau of Statistics: 1995 Census of Population and Housing. Jerusalem, Israel Central Bureau of Statistics, 1998.
10.
Shalev V, Chodick G, Goren I, Silber H, Kokia E, Heymann AD: The use of an automated patient registry to manage and monitor cardiovascular conditions and related outcomes in a large health organization. Int J Cardiol 2011;152:345-349.
11.
Chodick G, Heymann AD, Shalev V, Kookia E: The epidemiology of diabetes in a large Israeli HMO. Eur J Epidemiol 2003;18:1143-1146.
12.
World Health Organization: BMI Classification: Global Database on Body Mass Index, 2006.
13.
IBM Corp.: IBM SPSS Statistics for Windows. Armonk, IBM Corp., 2012.
14.
Mehta P, Antao V, Kaye W, Sanchez M, Williamson D, Bryan L, Muravov O, Horton K: Prevalence of amyotrophic lateral sclerosis - United States, 2010-2011. MMWR Suppl 2014;63:1-14.
15.
Logroscino G, Traynor BJ, Hardiman O, Chio A, Couratier P, Mitchell JD, Swingler RJ, Beghi E: Descriptive epidemiology of amyotrophic lateral sclerosis: new evidence and unsolved issues. J Neurol Neurosurg Psychiatry 2008;79:6-11.
16.
Turner MR: Increased premorbid physical activity and amyotrophic lateral sclerosis: born to run rather than run to death, or a seductive myth? J Neurol Neurosurg Psychiatry 2013;84:947.
17.
Korner S, Kollewe K, Ilsemann J, Muller-Heine A, Dengler R, Krampfl K, Petri S: Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis. Eur J Neurol 2013;20:647-654.
18.
Mitchell CS, Hollinger SK, Goswami SD, Polak MA, Lee RH, Glass JD: Antecedent disease is less prevalent in amyotrophic lateral sclerosis. Neurodegener Dis 2015;15:109-113.
19.
Hollinger SK, Okosun IS, Mitchell CS: Antecedent disease and amyotrophic lateral sclerosis: what is protecting whom? Front Neurol 2016;7:47.
20.
Millul A, Beghi E, Logroscino G, Micheli A, Vitelli E, Zardi A: Survival of patients with amyotrophic lateral sclerosis in a population-based registry. Neuroepidemiology 2005;25:114-119.
21.
Traxinger K, Kelly C, Johnson BA, Lyles RH, Glass JD: Prognosis and epidemiology of amyotrophic lateral sclerosis: analysis of a clinic population, 1997-2011. Neurol Clin Pract 2013;3:313-320.
22.
Pastula DM, Coffman CJ, Allen KD, Oddone EZ, Kasarskis EJ, Lindquist JH, Morgenlander JC, Norman BB, Rozear MP, Sams LA, Sabet A, Bedlack RS: Factors associated with survival in the national registry of veterans with ALS. Amyotroph Lateral Scler 2009;10:332-338.
23.
del Aguila MA, Longstreth WT Jr, McGuire V, Koepsell TD, van Belle G: Prognosis in amyotrophic lateral sclerosis: a population-based study. Neurology 2003;60:813-819.
24.
Marin B, Couratier P, Arcuti S, Copetti M, Fontana A, Nicol M, Raymondeau M, Logroscino G, Preux PM: Stratification of ALS patients' survival: a population-based study. J Neurol 2016;263:100-111.
25.
Cronin S, Hardiman O, Traynor BJ: Ethnic variation in the incidence of ALS: a systematic review. Neurology 2007;68:1002-1007.
26.
Drory VE, Artmonov I: Earlier onset and shorter survival of amyotrophic lateral sclerosis in Jewish patients of north African origin. A clue to modifying genetic factors? J Neurol Sci 2007;258:39-43.
27.
Radunovic A, Annane D, Rafiq MK, Mustfa N: Mechanical ventilation for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 2013;3:CD004427.
28.
Miller RG, Jackson CE, Kasarskis EJ, England JD, Forshew D, Johnston W, Kalra S, Katz JS, Mitsumoto H, Rosenfeld J, Shoesmith C, Strong MJ, Woolley SC: Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the quality standards subcommittee of the American academy of neurology. Neurology 2009;73:1218-1226.
29.
Albert SM, Wasner M, Tider T, Drory VE, Borasio GD: Cross-cultural variation in mental health at end of life in patients with ALS. Neurology 2007;68:1058-1061.
30.
Rabkin J, Ogino M, Goetz R, McElhiney M, Marziliano A, Imai T, Atsuta N, Morita M, Tateishi T, Matsumura T, Mitsumoto H: Tracheostomy with invasive ventilation for ALS patients: neurologists' roles in the US and Japan. Amyotroph Lateral Scler Frontotemporal Degener 2013;14:116-123.
31.
Rabkin J, Ogino M, Goetz R, McElhiney M, Hupf J, Heitzman D, Heiman-Patterson T, Miller R, Katz J, Lomen-Hoerth C, Imai T, Atsuta N, Morita M, Tateishi T, Matsumura T, Mitsumoto H: Japanese and American ALS patient preferences regarding TIV (tracheostomy with invasive ventilation): a cross-national survey. Amyotroph Lateral Scler Frontotemporal Degener 2014;15:185-191.
32.
Al-Chalabi A, Hardiman O: The epidemiology of ALS: a conspiracy of genes, environment and time. Nat Rev Neurol 2013;9:617-628.
33.
Beard JD, Kamel F: Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis etiology and survival. Epidemiol Rev 2015;37:55-70.
34.
Traynor BJ, Alexander M, Corr B, Frost E, Hardiman O: Effect of a multidisciplinary amyotrophic lateral sclerosis (ALS) clinic on ALS survival: a population based study, 1996-2000. J Neurol Neurosurg Psychiatry 2003;74:1258-1261.
35.
Montel S, Albertini L, Desnuelle C, Spitz E: The impact of active coping strategies on survival in ALS: the first pilot study. Amyotroph Lateral Scler 2012;13:599-601.
36.
Zach N, Ennist DL, Taylor AA, Alon H, Sherman A, Kueffner R, Walker J, Sinani E, Katsovskiy I, Cudkowicz M, Leitner ML: Being PRO-ACTive: what can a clinical trial database reveal about ALS? Neurotherapeutics 2015;12:417-423.
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