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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