Which statement is true about ALS sex distribution at younger ages?

• A. Men exceed women at younger ages
• B. Women exceed men at younger ages
• C. No difference between sexes
• D. Data are inconclusive regarding sex differences

Answer: (A)

The important idea is that how often ALS occurs differs by age and sex, with younger ages showing a male predominance. Across studies, more men than women are diagnosed with ALS in younger age groups, while the gap tends to narrow or even reverse somewhat in older ages. This pattern is thought to reflect a combination of hormonal influences—such as a potential protective effect of estrogen in premenopausal women—and historical differences in environmental or occupational exposures that have affected men more in younger cohorts. Because of these trends, saying that men exceed women at younger ages best captures the observed pattern.