TY - JOUR TI - Changing mortality for motor neuron disease in France (1968-2007): an age-period-cohort analysis AU - Gordon, Paul H AU - Artaud, Fanny AU - Aouba, Albertine AU - Laurent, Françoise AU - Meininger, Vincent AU - Elbaz, Alexis T2 - European journal of epidemiology AB - The incidence and mortality of motor neuron disease (MND) increase with age and appear to have increased with time. The examination of period and cohort effects using age-period-cohort (APC) models can help characterize temporal trends. Our objective was to describe mortality from MND in France (1968-2007), and to examine the role of age, period of death, and birth-cohort on changes in mortality. The number of people who died from MND and population statistics (1968-2007) were extracted from French national records. Annual standardized (age/sex) mortality ratios (SMRs) were computed. Using Poisson regression, APC models examined the relationship between mortality rates and age, period of death, and birth-cohort in subjects aged 40-89 years. Deviance/degrees-of-freedom ratios evaluated model fit; ratios close to one indicated adequate fit. Between 1968 and 2007, 38,863 individuals died from MND (mortality rate = 1.74/100,000); 37,624 were aged 40-89 years. SMRs increased from 54 (95% CI = 49-59) in 1968 to 126 (120-132) in 2007. Male-to-female ratios declined from 1.80 in 1968 to 1.45 in 2007. Changing mortality rates were best explained by cohort effects (deviance/degrees-of-freedom = 1.09). The relative risk of dying from MND increased markedly for persons born between 1880 and 1920, and more slowly after 1920. In conclusion, mortality rates for MND increased between 1968 and 2007, and more rapidly in women than men. This increase was better explained by the birth-cohort of individuals than by period effects. Changing environmental exposures may be a possible explanation and these findings warrant the continued search for environmental risk factors for MND. DA - 2011/09// PY - 2011 DO - 10.1007/s10654-011-9595-0 DP - NCBI PubMed VL - 26 IS - 9 SP - 729 EP - 737 J2 - Eur. J. Epidemiol. LA - eng SN - 1573-7284 ST - Changing mortality for motor neuron disease in France (1968-2007) KW - Adolescent KW - Adult KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Cohort Studies KW - European Continental Ancestry Group KW - Female KW - France KW - Humans KW - Male KW - Middle Aged KW - Models, Statistical KW - Mortality KW - Motor Neuron Disease KW - Population Surveillance KW - Risk Assessment KW - Risk Factors KW - Sex Distribution KW - Sex Factors KW - Time Factors ER -