The epidemiology of motor neuron diseases: a review of recent studies

As the incidence and mortality rates of motor neuron diseases (MNDs) have been reported to increase steadily over the 1950s-1980s decades, we compared the results of the most recent studies (1990s decade) with the ones reported for those earlier periods. The relevant literature was retrieved on a keyword basis from online medical and official death statistics databases. Fifteen European and North American studies were analyzed, for comparison with the results reported in review papers. The 1990s incidence and mortality rates of MND average at 1.89 per 100,000/year and 1.91 per 100,000/year, respectively, thus yielding increases of 46% and 57% over the 1960s-1970s decades, respectively. This increase, appears mainly due to Southern Europe countries, to female gender and to patients aged 75 years and over. Thus, the results of this analysis (i) confirm that the incidence of, and mortality from, MNDs continued to increase during the 1990s and, (ii) suggest that this increase could be partly due to increased life expectancy. Other factors might also contribute, such as better diagnosis since El Escorial criteria, and better accuracy of death certificate collection. However, a real increase in the incidence of MNDs, possibly related to environmental factors, cannot be excluded. (C) 2001 Elsevier Science B.V. All rights reserved.