Table of ContentsView AllTable of ContentsALS Age of OnsetEarly SignsCauses and Risk FactorsDemographic FactorsEnvironmental TriggersHow ALS ProgressesWhen to Seek CareFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
ALS Age of Onset
Early Signs
Causes and Risk Factors
Demographic Factors
Environmental Triggers
How ALS Progresses
When to Seek Care
Frequently Asked Questions
Withamyotrophic lateral sclerosis (ALS), your voluntary muscles may begin to cause you problems. The early signs may be so minor you may overlook them. The age of onset for ALS is most often between 55 and 75.
Initial signs of ALS can vary from muscle twitches or stiffness to difficulty swallowing. But this is a progressive neurological disease that ultimately makes movement impossible. It is also known as Lou Gehrig’s disease.
This article will discuss the age at which this condition usually strikes, what the earliest signs are likely to be, common risk factors, causes, how ALS progresses, and when to reach out for care.
Pekic / Getty Images
Early Signs and Symptoms of ALS
The first symptoms of ALS may be subtle, and you may excuse or ignore them. Some of these early symptoms include the following:
You may suddenly have trouble buttoning your coat or signing your name. Problems can start in different parts of the body.
Bulbar onset is a type of ALS that causes problems with swallowing or speech. Frequently tripping or running awkwardly are signs of limb onset ALS.
Unfortunately, most of the time, ALS occurs spontaneously without any apparent links to family history or genetic factors to explain it.This is called sporadic ALS.
But in up to 10% of cases, there can be a family connection. With familial ALS, there’s a 50% likelihood that each child will inherit the mutation (change in genetic material) that may lead to the disease.
People who served in the military are somewhat more likely to develop ALS than those who haven’t served. The Department of Veterans Affairs recognizes ALS as a service-related condition.
This may be due to the exposure to toxins released during warfare, environmental factors, or continually participating in highly strenuous activities.The latter may explain why professional athletes like National Football League players may be predisposed to this condition.ALS is commonly called Lou Gehrig’s disease after the professional baseball player.
Genetics
Genetics may play a role in ALS. In about two-thirds of cases in which ALS runs in families, a gene mutation can be identified. In fact, more than 25 genes may contribute to ALS.
Some of the key genes that may be implicated include the following:
While ALS can, unfortunately, affect anyone, some groups are more likely than others to develop the condition, including the following:
Note that Verywell Health prefers to use inclusive terminology. But when citing health authorities and research, the terms relating to gender and sex from those sources are used.
The environment that you live in also plays an important role. Here are some factors that are suspected to potentially trigger ALS:
ALS may start with minor issues such as difficulty fastening buttons or turning on the ignition in your car. This may seem perplexing at first. As the disease worsens, so do problems such as speaking, swallowing, moving, or breathing.
With time, weight loss may also become a problem. This occurs because those with ALS tend to burn calories more rapidly and they may also havedifficulty eating.
ALS mainly affects physical functions. Most people with ALS maintain their reasoning abilities and understanding of how the condition affects them.A small percentage of people with ALS may also have difficulties with language or making decisions.
ALS Stages of Progression
No test can quickly identify whether you have ALS. It takes nine months to two years for most people to be diagnosed with the condition.That’s because it’s easy to write off early mishaps as a product of aging.
Consult your healthcare provider as soon as you notice any signs of ALS. If your healthcare provider suspects ALS, they will likely refer you to aneurologist(a specialist in conditions affecting the central nervous system comprising the brain and spinal cord).
How Amyotrophic Lateral Sclerosis (ALS) Is Diagnosed
Summary
ALS can strike anyone. The condition can begin with minor problems such as muscle twitches, stiffness, or cramping and can progress from there. Typically this affects those between ages 55 and 75, but in some cases, even young children can have this progressive neurological condition.
In many cases, ALS can occur without obvious cause, but in some, there can be a hereditary connection. More than 25 genes associated with ALS have been identified. Environmental factors may have a role in ALS development.
Frequently Asked QuestionsThose most likely to get ALS are non-Hispanic Whites between ages 55 and 75. Also, ALS is 1.5 to 2 times more prevalent in military veterans. If you have a family member with ALS, you may also be at higher risk since about 5% to 10% of cases are familial, and it can be inherited from one parent.Learn MoreCauses and Risk Factor for ALSFor those with no family history, there’s a lifetime risk of this affecting about 1 in 400 people.This condition tends to be rare before age 40 and becomes much more prevalent with age. Some studies have found that with familial ALS, individuals have a threefold to tenfold greater risk of developing the condition.Learn MoreFamilial ALSIt can be easy to discount early symptoms. Studies from various countries have found a delay of around a year from symptom onset to diagnosis.There is, unfortunately, no clear-cut test to make the diagnosis.Learn More9 Early Signs of ALS
Those most likely to get ALS are non-Hispanic Whites between ages 55 and 75. Also, ALS is 1.5 to 2 times more prevalent in military veterans. If you have a family member with ALS, you may also be at higher risk since about 5% to 10% of cases are familial, and it can be inherited from one parent.Learn MoreCauses and Risk Factor for ALS
Those most likely to get ALS are non-Hispanic Whites between ages 55 and 75. Also, ALS is 1.5 to 2 times more prevalent in military veterans. If you have a family member with ALS, you may also be at higher risk since about 5% to 10% of cases are familial, and it can be inherited from one parent.
Learn MoreCauses and Risk Factor for ALS
For those with no family history, there’s a lifetime risk of this affecting about 1 in 400 people.This condition tends to be rare before age 40 and becomes much more prevalent with age. Some studies have found that with familial ALS, individuals have a threefold to tenfold greater risk of developing the condition.Learn MoreFamilial ALS
For those with no family history, there’s a lifetime risk of this affecting about 1 in 400 people.This condition tends to be rare before age 40 and becomes much more prevalent with age. Some studies have found that with familial ALS, individuals have a threefold to tenfold greater risk of developing the condition.
Learn MoreFamilial ALS
It can be easy to discount early symptoms. Studies from various countries have found a delay of around a year from symptom onset to diagnosis.There is, unfortunately, no clear-cut test to make the diagnosis.Learn More9 Early Signs of ALS
It can be easy to discount early symptoms. Studies from various countries have found a delay of around a year from symptom onset to diagnosis.There is, unfortunately, no clear-cut test to make the diagnosis.
Learn More9 Early Signs of ALS
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Amyotrophic lateral sclerosis (ALS).Daneshvar DH, Mez J, Alosco ML, et al.Incidence of and mortality from amyotrophic lateral sclerosis in National Football League athletes.JAMA Netw Open. 2021;4(12):e2138801. doi:10.1001/jamanetworkopen.2021.38801ALS Association.ALS genes and mutations.Centers for Disease Control and Prevention.Prevalence of amyotrophic lateral sclerosis.ALS Association.ALS risk factors.Cucovici A, Fontana A, Ivashynka A, et al.The impact of lifetime alcohol and cigarette smoking loads on amyotrophic lateral sclerosis progression: a cross-sectional study.Life (Basel). 2021;11(4):352. doi:10.3390/life11040352Proctor EA, Mowrey DD, Dokholyan NV.β-Methylamino-L-alanine substitution of serine in SOD1 suggests a direct role in ALS etiology.PLoS Comput Biol. 2019;15(7):e1007225. doi:10.1371/journal.pcbi.1007225Andrew A, Zhou J, Gui J, et al.Pesticides applied to crops and amyotrophic lateral sclerosis risk in the U.S.Neurotoxicology. 2021;87:128-135. doi:10.1016/j.neuro.2021.09.004Castanedo-Vazquez D, Bosque-Varela P, Sainz-Pelayo A, Riancho J.Infectious agents and amyotrophic lateral sclerosis: another piece of the puzzle of motor neuron degeneration.J Neurol. 2019;266(1):27-36. doi:10.1007/s00415-018-8919-3Tai H, Cui L, Shen D, Li D, Cui B, Fang J.Military service and the risk of amyotrophic lateral sclerosis: A meta-analysis.J Clin Neurosci. 2017;45:337-342. doi:10.1016/j.jocn.2017.08.035Longinetti E, Fang F.Epidemiology of amyotrophic lateral sclerosis: an update of recent literature.Curr Opin Neurol.2019;32(5):771-776. doi:10.1097/WCO.0000000000000730ALS Association.Obtaining an ALS diagnosis.Ryan M, Heverin M, McLaughlin RL, Hardiman O.Lifetime risk and heritability of amyotrophic lateral sclerosis.JAMA Neurol. 2019;76(11):1367-1374. doi:10.1001/jamaneurol.2019.2044Ingre C, Roos PM, Piehl F, Kamel F, Fang F.Risk factors for amyotrophic lateral sclerosis.Clin Epidemiol. 2015;7:181-93. doi:10.2147/CLEP.S37505
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Amyotrophic lateral sclerosis (ALS).Daneshvar DH, Mez J, Alosco ML, et al.Incidence of and mortality from amyotrophic lateral sclerosis in National Football League athletes.JAMA Netw Open. 2021;4(12):e2138801. doi:10.1001/jamanetworkopen.2021.38801ALS Association.ALS genes and mutations.Centers for Disease Control and Prevention.Prevalence of amyotrophic lateral sclerosis.ALS Association.ALS risk factors.Cucovici A, Fontana A, Ivashynka A, et al.The impact of lifetime alcohol and cigarette smoking loads on amyotrophic lateral sclerosis progression: a cross-sectional study.Life (Basel). 2021;11(4):352. doi:10.3390/life11040352Proctor EA, Mowrey DD, Dokholyan NV.β-Methylamino-L-alanine substitution of serine in SOD1 suggests a direct role in ALS etiology.PLoS Comput Biol. 2019;15(7):e1007225. doi:10.1371/journal.pcbi.1007225Andrew A, Zhou J, Gui J, et al.Pesticides applied to crops and amyotrophic lateral sclerosis risk in the U.S.Neurotoxicology. 2021;87:128-135. doi:10.1016/j.neuro.2021.09.004Castanedo-Vazquez D, Bosque-Varela P, Sainz-Pelayo A, Riancho J.Infectious agents and amyotrophic lateral sclerosis: another piece of the puzzle of motor neuron degeneration.J Neurol. 2019;266(1):27-36. doi:10.1007/s00415-018-8919-3Tai H, Cui L, Shen D, Li D, Cui B, Fang J.Military service and the risk of amyotrophic lateral sclerosis: A meta-analysis.J Clin Neurosci. 2017;45:337-342. doi:10.1016/j.jocn.2017.08.035Longinetti E, Fang F.Epidemiology of amyotrophic lateral sclerosis: an update of recent literature.Curr Opin Neurol.2019;32(5):771-776. doi:10.1097/WCO.0000000000000730ALS Association.Obtaining an ALS diagnosis.Ryan M, Heverin M, McLaughlin RL, Hardiman O.Lifetime risk and heritability of amyotrophic lateral sclerosis.JAMA Neurol. 2019;76(11):1367-1374. doi:10.1001/jamaneurol.2019.2044Ingre C, Roos PM, Piehl F, Kamel F, Fang F.Risk factors for amyotrophic lateral sclerosis.Clin Epidemiol. 2015;7:181-93. doi:10.2147/CLEP.S37505
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Amyotrophic lateral sclerosis (ALS).Daneshvar DH, Mez J, Alosco ML, et al.Incidence of and mortality from amyotrophic lateral sclerosis in National Football League athletes.JAMA Netw Open. 2021;4(12):e2138801. doi:10.1001/jamanetworkopen.2021.38801ALS Association.ALS genes and mutations.Centers for Disease Control and Prevention.Prevalence of amyotrophic lateral sclerosis.ALS Association.ALS risk factors.Cucovici A, Fontana A, Ivashynka A, et al.The impact of lifetime alcohol and cigarette smoking loads on amyotrophic lateral sclerosis progression: a cross-sectional study.Life (Basel). 2021;11(4):352. doi:10.3390/life11040352Proctor EA, Mowrey DD, Dokholyan NV.β-Methylamino-L-alanine substitution of serine in SOD1 suggests a direct role in ALS etiology.PLoS Comput Biol. 2019;15(7):e1007225. doi:10.1371/journal.pcbi.1007225Andrew A, Zhou J, Gui J, et al.Pesticides applied to crops and amyotrophic lateral sclerosis risk in the U.S.Neurotoxicology. 2021;87:128-135. doi:10.1016/j.neuro.2021.09.004Castanedo-Vazquez D, Bosque-Varela P, Sainz-Pelayo A, Riancho J.Infectious agents and amyotrophic lateral sclerosis: another piece of the puzzle of motor neuron degeneration.J Neurol. 2019;266(1):27-36. doi:10.1007/s00415-018-8919-3Tai H, Cui L, Shen D, Li D, Cui B, Fang J.Military service and the risk of amyotrophic lateral sclerosis: A meta-analysis.J Clin Neurosci. 2017;45:337-342. doi:10.1016/j.jocn.2017.08.035Longinetti E, Fang F.Epidemiology of amyotrophic lateral sclerosis: an update of recent literature.Curr Opin Neurol.2019;32(5):771-776. doi:10.1097/WCO.0000000000000730ALS Association.Obtaining an ALS diagnosis.Ryan M, Heverin M, McLaughlin RL, Hardiman O.Lifetime risk and heritability of amyotrophic lateral sclerosis.JAMA Neurol. 2019;76(11):1367-1374. doi:10.1001/jamaneurol.2019.2044Ingre C, Roos PM, Piehl F, Kamel F, Fang F.Risk factors for amyotrophic lateral sclerosis.Clin Epidemiol. 2015;7:181-93. doi:10.2147/CLEP.S37505
National Institute of Neurological Disorders and Stroke.Amyotrophic lateral sclerosis (ALS).
Daneshvar DH, Mez J, Alosco ML, et al.Incidence of and mortality from amyotrophic lateral sclerosis in National Football League athletes.JAMA Netw Open. 2021;4(12):e2138801. doi:10.1001/jamanetworkopen.2021.38801
ALS Association.ALS genes and mutations.
Centers for Disease Control and Prevention.Prevalence of amyotrophic lateral sclerosis.
ALS Association.ALS risk factors.
Cucovici A, Fontana A, Ivashynka A, et al.The impact of lifetime alcohol and cigarette smoking loads on amyotrophic lateral sclerosis progression: a cross-sectional study.Life (Basel). 2021;11(4):352. doi:10.3390/life11040352
Proctor EA, Mowrey DD, Dokholyan NV.β-Methylamino-L-alanine substitution of serine in SOD1 suggests a direct role in ALS etiology.PLoS Comput Biol. 2019;15(7):e1007225. doi:10.1371/journal.pcbi.1007225
Andrew A, Zhou J, Gui J, et al.Pesticides applied to crops and amyotrophic lateral sclerosis risk in the U.S.Neurotoxicology. 2021;87:128-135. doi:10.1016/j.neuro.2021.09.004
Castanedo-Vazquez D, Bosque-Varela P, Sainz-Pelayo A, Riancho J.Infectious agents and amyotrophic lateral sclerosis: another piece of the puzzle of motor neuron degeneration.J Neurol. 2019;266(1):27-36. doi:10.1007/s00415-018-8919-3
Tai H, Cui L, Shen D, Li D, Cui B, Fang J.Military service and the risk of amyotrophic lateral sclerosis: A meta-analysis.J Clin Neurosci. 2017;45:337-342. doi:10.1016/j.jocn.2017.08.035
Longinetti E, Fang F.Epidemiology of amyotrophic lateral sclerosis: an update of recent literature.Curr Opin Neurol.2019;32(5):771-776. doi:10.1097/WCO.0000000000000730
ALS Association.Obtaining an ALS diagnosis.
Ryan M, Heverin M, McLaughlin RL, Hardiman O.Lifetime risk and heritability of amyotrophic lateral sclerosis.JAMA Neurol. 2019;76(11):1367-1374. doi:10.1001/jamaneurol.2019.2044
Ingre C, Roos PM, Piehl F, Kamel F, Fang F.Risk factors for amyotrophic lateral sclerosis.Clin Epidemiol. 2015;7:181-93. doi:10.2147/CLEP.S37505
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
