Participation in Physical Activity and Risk for Amyotrophic Lateral Sclerosis Mortality Among Postmenopausal XXXX .

@entity1 @entity301 @entity0 @entity746
IMPORTANCE: @entity746 ( @entity746 ) is a progressive, fatal disease with no known cause. Case studies primarily of athletes and several case-control studies have suggested that high levels of strenuous physical activity (PA) may increase the risk for @entity746 . This relationship has yet to be evaluated among @entity1 in population-based cohort studies. OBJECTIVE: To evaluate the relationship between PA and risk for @entity746 mortality in a large cohort of postmenopausal @entity1 . DESIGN, SETTING, AND @entity1 : The @entity1 's Health Initiative (WHI) enrolled 161   809 postmenopausal @entity1 , aged 50 to 79 years (mean [SD] age, 63.6 [7.24] years), between 1993 and 1998 into either a clinical trial or an observational study at 40 clinical research centers across the United States. We conducted a cohort study from November 2014 to September 2015 using baseline and mortality data during an average of 9.6 years of follow-up from the entire WHI cohort, through September 1, 2013 (with 1.1% lost to follow-up), to address whether there is a relationship between PA and @entity746 mortality. EXPOSURES: The WHI assessed frequency and duration of mild, moderate, and strenuous PA at baseline via self-administered questionnaire. MAIN OUTCOMES AND MEASURES: Underlying cause of death from @entity746 collected from death certificates. RESULTS: The WHI enrolled 161   809 @entity1 , of whom 165 died of @entity746 ; @entity1 who died of @entity746 were older (median age, 66 years; interquartile range, 61-69 years) compared with the total WHI study population (median age, 63 years; interquartile range, 57-69 years). Age-adjusted @entity746 mortality rates varied from 7.4 (95% CI, 5.5-9.9)/100   000 @entity1 -years for no strenuous PA to 10.6 (95% CI, 5.6-20.0)/100   000 @entity1 -years for strenuous PA 3 or more days per week (P   =   .07). Adjusted for age and body mass index (calculated as weight in kilograms divided by height in meters squared), the odds ratio for death from @entity746 for @entity1 with strenuous PA 3 or more days per week compared with no reported strenuous PA was 1.56 (95% CI, 1.02-2.37; P   =   .04). CONCLUSIONS AND RELEVANCE: To our knowledge, this is the first cohort study to report an increased risk for @entity746 mortality associated with strenuous PA in postmenopausal @entity1 . The association between strenuous PA and @entity746 risk observed does not compromise the overall benefit of strenuous PA for total mortality, @entity301 , and @entity0 reported in other WHI investigations, but it may provide an important clue to the etiology of @entity746 , if replicated by other studies.
