The Enigma of the Global Rise in ALS: Genetic, Environmental Factors, and Future Challenges

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, has shown an increase in its global incidence. According to projections from the U.S. Centers for Disease Control and Prevention (CDC), a significant rise in the number of cases is expected by 2030. This phenomenon raises important questions about the contributing factors and the strategies needed to address this neurodegenerative disease.

Although the exact cause of ALS remains unknown, both genetic and environmental factors are recognized as playing critical roles. Approximately 5–10% of cases are hereditary, linked to mutations in genes such as C9ORF72, SOD1, and FUS. However, the majority of cases are sporadic, suggesting a strong influence from external factors. Recent studies have identified exposure to environmental toxins—such as heavy metals and pesticides—as well as smoking and military service as possible risk factors. Additionally, exposure to neurotoxins produced by blue-green algae, which thrive due to climate change, has been associated with non-genetic ALS cases.

The aging of the global population is another key contributor to the rise in cases, as ALS typically appears between the ages of 55 and 75. This demographic trend, combined with increased awareness and improved diagnostic methods, may partially explain the observed increase.

In light of this scenario, it is essential to strengthen interdisciplinary research that explores the interaction between genetics and the environment. Initiatives such as Project MinE, which aims to sequence the genomes of thousands of patients, are important steps toward understanding the disease. Furthermore, public health policies must be implemented to reduce exposure to known risk factors and promote healthier lifestyles.

ALS represents a complex challenge that requires a coordinated global response. Only through a combination of scientific research, public awareness, and effective policy can we confront the growing impact of this disease in the coming decades.