How is an individual prognosis for ALS determined?

The progression of symptoms and the associated prognosis vary greatly from person to person. ALS leads to a shortened life expectancy due to progressive malnutrition (dysphagia) or respiratory failure (neuromuscular hypoventilation). However, the survival prognosis is determined by numerous factors—survival time is therefore individual and cannot be generalized. The severity of symptoms and the ALS progression rate (ALSPR) are assessed using the ALS Functional Rating Scale (ALSFRS-R)—a scale for both self-assessment and assessment by others that can be completed by physicians, patients, and caregivers using a printed questionnaire or the ALS app. Measurements ofslow vital capacity (SVC), peak cough flow(PCF), and body mass index (BMI) aid in decision-making regarding ventilatory and nutritional therapy or palliative care. The biomarker neurofilament light chain (NfL) correlates with ALS progression and also contributes to prognosis assessment.