Each person's disease course is unique. From the time of diagnosis, most patients die within three to five years. Around 30 percent of ALS patients are alive beyond five years after diagnosis, and 10 to 20 percent of patients survive 10 years or more. Survival beyond 20 years is possible but rare. Factors associated with more favorable survival rates include a younger age, male gender, and limb rather than bulbar symptom onset. For more information on the disease course, see Medical Management.