Factors Influencing the Loss of Ambulation in Patients With Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study

Background and Aims Loss of ambulation in patients with amyotrophic lateral sclerosis (ALS) reduces their social participation and quality of life. Moreover, loss of ambulation is one of the biggest obstacles for patients and their caretakers. However, prognostic factors for loss of ambulation in patients with ALS have not been clarified. This study aimed to investigate the time to loss of ambulation in Japanese patients with ALS and to identify factors associated with loss of ambulation. Methods Overall, 62 patients with ALS were enrolled. Survey items included patient background, pre‐existing medical conditions, and laboratory data. Cox proportional hazards regression analysis was performed with the time to loss of ambulation as the dependent variable and age at onset, sex, onset type, duration to diagnosis, ALS severity, diabetes mellitus (DM), and %forced vital capacity (%FVC) as independent variables. Results The median time to loss of ambulation for all ALS patients was 16.5 (10.0–31.3) months. Cox regression analysis revealed a significant association between duration to diagnosis (HR: 0.94, 95% CI: 0.91–0.97, p < 0.001) and DM (HR: 3.30, 95% CI: 1.62–6.69, p < 0.001). Conclusions Time to diagnosis and history of diabetes are important factors associated with the time to loss of ambulation in patients with ALS. Trial Registration Retrospectively registered.