Neurology

Objectives To analyse longitudinal change in motor neuron disease (MND) mortality in Australia from 1986 to 2023. Design Australian population-based study of MND mortality. Setting All MND mortality and Australian population data from 1 January 1986 to 31 December 2023 were obtained from the Australian Bureau of Statistics. Main Outcome Measures MND mortality records were analysed, and certified deaths were summarised by year of registration. MND mortality rates, 95% confidence intervals (CIs) and Joinpoint regression trends were calculated. Data were further subset by demographic and geographical categories to report Australian MND mortality by age group, sex, state/territory location and remoteness areas classification. Results In Australia, the total number of MND deaths more than tripled over the past 37years, from 238 in 1986 to 781 in 2023. The unadjusted mortality rate in 1986 was 1.49 (95% CI, 1.30–1.69) per 100,000 population and increased to 2.93 (95% CI, 2.73–3.14) per 100,000 population by 2023. After age standardisation, the annual percentage change across 1986–2023 was determined to be 0.47% (95% confidence limit, 0.16–0.86). Joinpoint modelling suggests a more recent reduction in adjusted mortality rates. In 2023, MND accounted for 0.43% of all-cause deaths in Australia, increasing from 0.21% in 1986. The number of MND deaths in Australia peaked at age 70–79years. MND mortality was higher among men than women (rate ratio, 1.41; 95% CI, 1.33–1.51). MND mortality rates were similar among New South Wales, Victoria and Queensland (2.93, 3.08 and 2.85 per 100,000 population, respectively), with higher rates in South Australia and Tasmania (3.44 and 4.12 per 100,000 population, respectively). MND mortality rates were higher in inner and outer regional areas (3.90 and 3.24 per 100,000 population, respectively) compared with major cities (2.79 per 100,000 population). Conclusions Adjusted MND mortality rates in Australia increased over 37years.

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Genomic tests present additional challenges compared with other pathological investigations

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