What Age Do ALS Patients Develop Symptoms? From 40 to 70, Who Is Most at Risk?
What Age Do ALS Patients Develop Symptoms? From 40 to 70, Who Is Most at Risk?
“At what age does ALS begin?” This is one of the first questions people ask about this rare disease—and one of the hardest to answer.
One of the most common questions about ALS is: What age do ALS patients usually develop symptoms? Also known as Amyotrophic Lateral Sclerosis (ALS), this neurodegenerative disease gradually paralyzes the body by destroying motor neurons. As the disease progresses, patients lose muscle strength, the ability to speak, move, and eventually breathe.
In this article, we’ll explore the typical age range when ALS (also known as Lou Gehrig’s disease) starts, identify high-risk groups, and answer another frequently asked question: How long can a person with ALS live?
Further reading
What Age Does ALS Usually Start? Typically Between 40 and 70
Based on medical data, ALS most commonly develops between the ages of 40 and 70, with an average onset age of 55. This means it usually appears during midlife or early old age.
Although there are rare cases of people being diagnosed in their 20s or 30s, these are known as “juvenile ALS,” which often progresses more slowly and may present differently.
Gender Differences: Slightly Higher Risk for Men
Studies show that men are about 20% more likely to develop ALS than women, especially at younger ages. However, this gender gap narrows as people get older. By the time individuals reach their 60s and 70s, the difference becomes negligible.
Rare, But Not Unfamiliar
ALS is classified as a rare disease. In Taiwan, about 100 to 200 new cases are diagnosed each year, with the total number of patients approaching 1,000. In the U.S., approximately 5,000 to 6,000 new cases are reported annually.
According to the CDC, the number of ALS cases in the U.S. reached 32,893 in 2022 and is projected to rise to 36,308 by 2030, with the most significant increase (25%) occurring among individuals over 66 years old.
Globally, the number of ALS patients is expected to grow by nearly 70% by 2040, reaching close to 380,000.
Who Is at Higher Risk?
Besides age and gender, research has identified other groups with increased risk for ALS:
1. Military Veterans
Veterans are 1.5 to 2 times more likely to develop ALS compared to the general population. The reasons aren’t fully understood but may include exposure to lead, pesticides, or other environmental toxins during service.
2. Individuals With a History of Head Trauma
Some studies suggest that serious head injuries may increase the risk of ALS later in life. However, more research is needed to confirm a direct link.
3. People With a Family History of ALS
Approximately 5% to 10% of ALS cases are familial, meaning they’re inherited. These individuals often develop symptoms at a younger age, and the disease may progress in a more symmetrical or unique pattern.
4. Smoking (Potential High-Risk Factor)
A 2024 study published in Tobacco Induced Diseases revealed a positive correlation between smoking and ALS, making smoking cessation one of the suggested ways to reduce ALS risk. However, there is still no definitive evidence identifying specific key risk factors, so the best recommendation remains avoiding potential risks whenever possible.
5. Environmental Pollution (Potential High-Risk Factor)
A 2025 article in the European Journal of Neurology reported that residents living near farmlands in Northwestern Italy had a significantly higher risk of developing ALS. Moreover, the average age of onset was 3.4 years earlier than the general population. This may be linked to environmental pollutants commonly found near agricultural areas, such as pesticides.
How Long Can a Person With ALS Live?
Another major question: How long can a person with ALS live?
According to medical statistics, the average life expectancy after diagnosis is between 2 to 5 years. However, this can vary dramatically depending on the individual. Some experience rapid progression, while others live much longer.
One of the most notable exceptions is Stephen Hawking, who lived more than 50 years after being diagnosed at age 21.
(picture: byNASA/Paul E. Alers – https://images.nasa.gov/details/200804210008HQ, public domain, https://commons.wikimedia.org/w/index.php?curid=16350791)
Survival time depends on several factors:
Age at onset and type of ALS (bulbar onset tends to progress faster)
Timing of diagnosis and treatment initiation
Availability of respiratory and nutritional support
Quality of mental and social support systems
Famous Individuals With ALS Prove That Willpower Endures
While ALS gradually takes away physical mobility, many well-known individuals have shown that the human spirit can remain unshaken:
Stephen Hawking: Lived over 50 years with ALS and transformed our understanding of the universe.
Stephen Hillenburg: Creator of SpongeBob SquarePants, who continued working after his diagnosis.
Yasuhiko Funago: A Japanese member of parliament diagnosed at 41, who later became a voice for the disabled community.
Cai Lei: Former VP of BOE Technology in China, diagnosed in 2019, has since dedicated himself to ALS research and data platforms.
In addition, several public figures have sadly passed away due to ALS, including New York Senator Jacob Javits, former U.S. Vice President Henry A. Wallace, actor Waymond Lee from Mad Men, former Taiwanese legislator Lin Cheng-Feng, and TV personality Ma Zhi-Qin.
Their life stories serve as powerful reminders: while we can’t predict disease, we can choose how we respond to it—and that choice is always in our hands.
You Can’t Change the Risk, But You Can Choose How to Face It
ALS most commonly begins between the ages of 40 and 70, with the average age around 55. Men face slightly higher risk, and age remains the most significant factor.
While there is currently no cure for ALS, knowing the onset age range and risk factors helps promote early diagnosis and intervention. If you or a loved one experiences muscle weakness, twitching, or difficulty swallowing, it’s important to consult a neurologist as early as possible.
And as for the question, “How long can a person with ALS live?” — there’s no one-size-fits-all answer. What truly matters is timely medical care, strong support, and never giving up.
