My mother died in 2011 of ALS at 74. I recognized her speech changes (sounded like she'd had a glass or two of wine) perhaps a year before she admitted or realized what she had.
Over the past 6-8 months, I will "'mis-swallow" at least once per meal, get food in my windpipe, and have to cough considerably to clear it. Simultaneously, I occasionally find it hard to read out-loud without tangling up the words - talking is often the same way.
Is ALS hereditary enough to be concerned? I'm 52.