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New research · Neurology
Neurology · 4d
Cohort studyNeurology · 2026

Association of Military Branch and Rank With Amyotrophic Lateral Sclerosis Incidence Among United States Veterans.

Andrea L Roberts, Alexandre D Vilela Braga, Ian W Tang … Marc G Weisskopf
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NeurologyCohort study

Male military officers are associated with a higher rate of amyotrophic lateral sclerosis.

Association of Military Branch and Rank With Amyotrophic Lateral Sclerosis Incidence Among United States Veterans.

Andrea L Roberts … Marc G Weisskopf
Neurology · 2026
Background

Military service is one of the most consistent risk factors for the development of amyotrophic lateral sclerosis (amyotrophic lateral sclerosis), but little is known about what aspects of military service matter.

Purpose

We aimed to ascertain the association of United States (United States) military branch and rank with incident amyotrophic lateral sclerosis.

Methods

We conducted a longitudinal cohort study including all veterans with a Veterans Health Administration encounter from January 1, 2000, through October 1, 2024, and more than 2 years of follow-up.

n = 9,157,938 men
Results

male officers had a higher rate of amyotrophic lateral sclerosis than enlisted personnel

HR by subgroup · 95% CI
null = 1
Navy
1.15
Coast Guard
1.26
rates of ALS and service in the Marines
0.78
rates than enlisted personnel
1.64
rates than enlisted personnel
1.72
More results

The analytic sample comprised 9,157,938 men (13,935 incident amyotrophic lateral sclerosis cases, mean age = 56.9 years) and 784,941 women (484 cases, mean age = 42.4 at start of follow up).

More results

Among men, compared with service in the Army, service in the Air Force (hazard ratio [HR] = 1.29, 95% CI 1.23-1.35), Navy (HR = 1.15, 95% CI 1.10-1.20), and Coast Guard (HR = 1.26, 95% CI 1.06-1.50) was associated with higher rates of amyotrophic lateral sclerosis and service in the Marines a lower rate (HR = 0.78, 95% CI 0.68-0.88).

“
Conclusion

It is imperative to identify relevant exposures to reduce harm to service members and, potentially, civilians with similar exposures.

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