Maybe if the ALSA and the associated ALS communities could get the CDC (here in the U.S. anyway) to require all Neurologists to report ALS diagnoses... estimates could be become true numbers instead. A lot of people 55 and older may use computers in some form with their jobs... cursor clickers and one finger entries but many lack actual typing and composition skills to relate their story. (Plumbers, carpenters, painters, mechanics, truck drivers, roofers, and etc).
No one wants the numbers to rise. But... there are some indicators it may be happening.