Alteration of nutritional status at diagnosis is a prognostic factor for survival of ALS patients.

International audienceObjectives: The aims were to analyze changes in nutritional parameters from diagnosis of ALS to death and to assess their relationships with survival at the time of diagnosis and during follow-up. Methods: Ninety-two ALS patients were included and clinically assessed every three months (ALS FRS, MMT, forced vital capacity, weight, BMI, percent weight loss). Bioimpedance was performed to evaluate body composition (fat-free mass, fat mass and hydration status) and phase angle. Survival analyses were performed from diagnosis to death or censoring date using a Cox model. Results: The evolution of nutritional parameters in ALS patients was marked by significant decreases in weight, BMI, fat-free mass and phase angle, and increased fat mass. We identified an adjusted 30% increased risk of death for a 5% decrease from usual weight at time of diagnosis (Relative Risk (RR): 1.30 95%CI 1.08-1.56). During follow-up, we identified adjusted 34% (95%CI 18-51) and 24% (95%CI 13-36) increased risks of death associated with each 5% decrease in usual weight and each unit decrease in usual BMI, respectively (p