Marital status is a prognostic factor in amyotrophic lateral sclerosis

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Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons and leading to a complete paralysis and death.1 Survival from onset to death/tracheostomy is generally <5 years,1 although several studies report longer survival, being more than 10 years in 5%‐10% of the patients (reviewed in Ref. 4). Because the variable clinical course of the disease, information on prognosis is important in order to provide better patient care and to improve the design of clinical trials.
In the recent years, several variables have been reported to predict ALS prognosis, for example, age and site of onset, sex, nutritional status, respiratory function, as measured by forced vital capacity (FVC%) diagnostic delay, marital status, and the rate of disease progression.2
Concerning the marital status, an early report documented a shorter survival in unmarried ALS patients, being mostly older women with a longer diagnostic delay.2 The authors interpreted these observations by emphasizing the role of a spouse/partner in recognition of the health problem and pushing the partner for a clinical evaluation.2 Furthermore, a study showed that unmarried ALS patients, because the lack of a partner, were more likely to die in an acute care facility or in a nursing home.10 Moreover, unmarried patients were shown to be less prone to proceed to a tracheostomy.11 Given that the management of a tracheostomy is very complex, the authors of that study suggested that the presence of a caregiving spouse/partner would make the ALS patient, who needs a tracheostomy, more willing to accept this invasive life‐saving procedure.
Taken together, these data point to the marital status as an important prognostic factor in ALS. To strengthen this hypothesis, in this work, we further evaluated the prognostic value of the marital status in a relatively large cohort of patients with ALS.

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