Comorbidities and Life Expectancy in Multiple Sclerosis

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People with multiple sclerosis can expect to live fairly long lives; however their life expectancy is about six to seven years shorter than the general population, according to a study published in Neurology.

Ruth Ann Marrie, MD, of the University of Manitoba in Canada, and colleagues compared health data and death records of 5,797 people with multiple sclerosis to 28,807 sex- and age-matched controls from the Manitoba region of Canada. The median duration of survival among people with MS was 75.9 years compared to 83.4 years in the general population.

Among both cohorts, diabetes, ischemic heart disease, depression, anxiety, and chronic lung disease was associated with greater mortality risk, however the association between mortality, chronic lung disease, diabetes, hypertension, and ischemic heart disease was lower in the MS population. The most common cause of death in the MS population were diseases of the nervous system and circulatory system, while infectious diseases and diseases of the respiratory system were also associated with a higher mortality rate in the MS population. Overall, MS was associated with a two-fold increased risk of death (adjusted hazard ratio 2.40; 95% confidence interval: 2.24–2.58).

Although comorbidity was associated with an increased risk of mortality in people with MS, comorbidity did not preferentially increase mortality risk in people with MS as compared to the general population. 

Elderly woman walking
Comorbidities and Life Expectancy in Multiple Sclerosis

Multiple sclerosis (MS) affects more than 2.5 million persons worldwide. It is a disease with unexplained heterogeneity in outcomes, including survival. Some studies report that survival in MS has improved over the last 40 to 50 years.

However, most studies suggest that survival remains lower than expected for an age- and sex-matched population without MS. The reasons for this survival disparity are incompletely understood, as are the relative contributions of disease-related complications and competing causes to mortality. Complications of MS, such as infection, have an important role. Causes unrelated to MS, such as cardiovascular disease, seem to contribute to the higher than expected mortality in other studies. However, the contribution of comorbidity to survival in MS has received little attention apart from one Finnish study focused on neurologic comorbidities.

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