A recent study led by Michigan Medicine indicates that residing in a disadvantaged community may reduce a person’s survival time with amyotrophic lateral sclerosis (ALS) by more than 30%.
ALS is a progressive and incurable disease that leads to muscle deterioration and loss of control.
Typically, individuals diagnosed with ALS survive between two to four years, although some can live much longer.
The research, involving over 1,000 patients diagnosed with ALS from 2012 to mid-2024, found that those from the least advantaged neighborhoods experienced up to a 37% shorter survival period compared to individuals from more affluent areas.
Researchers from the University of Michigan utilized the Area Deprivation Index, developed by the University of Wisconsin, which assesses neighborhood disadvantage based on factors like income, education, job opportunities, and housing conditions.
The findings were published in Neurology, the official journal of the American Academy of Neurology.
“Our findings reveal a strong connection between negative social health factors and reduced survival rates in ALS patients,” remarked senior author Stephen Goutman, M.D., M.S., the Harriet Hiller Research Professor, director of the Pranger ALS Clinic, and associate director of the ALS Center of Excellence at the University of Michigan.
“For many years, we have identified the ALS ‘exposome’ as encompassing how environmental factors throughout a person’s life influence their risk of developing ALS and their longevity with the disease. The lived environment—essentially, the social exposome—plays a critical role in shaping the overall exposome and must be considered. Additionally, understanding the influence of socioeconomic conditions on ALS survival is vital for making life with ALS more manageable and addressing disparities in healthcare.”
Caring for someone with ALS can be exceedingly expensive, with out-of-pocket costs potentially reaching $250,000 annually, as stated by the ALS Association.
The study did not reveal the reasons behind the differences in survival rates; however, researchers suggest that patients with more resources tend to access additional support, helping to alleviate the strain on family caregivers.
“Social determinants of health can uniquely affect ALS due to the significant costs associated with care, making it essential to take these factors into account and emphasize the urgent need for interventions to address health disparities in ALS treatment,” stated first author Dae Gyu Jang, Ph.D., a postdoctoral fellow in the U-M Health Department of Neurology.
Other studies indicate that residing in economically strained areas correlates with a heavier burden of Alzheimer’s Disease and related dementias.
According to researchers, living in underprivileged communities is also tied to increased inflammation and accelerated biological aging, both of which may influence the progression of ALS.
“This is a critical field that needs more focus to enhance the quality of life for those living with ALS,” Goutman concluded.
“This research could also underscore the essential adjustments needed in care systems for individuals with ALS to alleviate the caregiving load.”
