Multiple sclerosis (MS) has become more common in the UK over the past two decades, but people diagnosed more recently are living longer, according to a study led by University College London (UCL).
The change reflects major advances in MS diagnosis and care. But the researchers found that social inequality still increases the risks for many, with higher rates of obesity and smoking in more deprived areas, as well as higher death rates.
“People with MS are living longer than ever before, thanks to better care, disease-modifying treatments, and earlier diagnosis, but much more is still needed,” Olga Cecrelli, PhD, research professor at UCL, said in a university press release. “Tackling smoking, obesity and disparities in access to diagnoses and care can reduce preventable deaths and help MS patients stay healthy longer.”
study,”Thirty-year trends in multiple sclerosis prevalence, lifestyle factors and mortality in England”, published as a research letter JAMA Neurology.
In MS, the immune system attacks the central nervous system, which includes the brain and spinal cord. It can cause symptoms such as numbness, numbness, limb weakness, and vision loss.
MS care has changed significantly in recent decades, with earlier diagnosis, widespread use of disease-modifying therapies, and increasing efforts to target lifestyle factors such as smoking and obesity. However, it is not clear how these changes have changed the overall landscape of MS at the population level – particularly the effects of prevalence (number of new cases), survival, and socioeconomic deprivation.
30 years of data showing trends
UCL researchers analyzed 30 years of data from a large database of primary care records covering almost a quarter of the English population.
The results showed that the number of people living with MS increased from 21,997 in 2000 to 37,669 in 2020. After adjusting for age, sex, and region, the researchers estimated that about 107 of every 100,000 people were living with the condition in 2000, but that number had doubled in 2002. This corresponds to around 131,000 people living with MS in the UK in 2020.
On average, the spread increased by 6% every year. Assuming this trend continues over time, researchers estimate that there are currently about 190,000 people living with MS in the country.
While the prevalence of MS has increased, survival has improved. People diagnosed after 2000 were more likely to live to age 80 than the overall group (43.8% vs. 34.5%), and the death rate decreased by approximately 12% with each year after diagnosis.
The researchers also pointed out some disparities. For example, while the death rate was higher in wealthy areas, the death rate was higher in deprived areas. This may indicate that people in deprived areas are less likely to be diagnosed early and have limited access to treatment.
People living in deprived areas were also more likely to smoke or be obese, both of which are associated with worse outcomes.
Indeed, smoking and obesity were consistently associated with shorter survival, while smoking cessation was associated with better outcomes. These lifestyle factors may explain some of the differences seen across socioeconomic groups.
“We know that smoking and obesity can worsen MS, and this study suggests that targeted support around smoking cessation and maintaining a healthy weight can also be critical in reducing inequalities in MS outcomes,” said Catherine Godbold, PhD, senior manager of research communications at MS Society UK, which supported part of the study.
The findings overall show that while health care improvements over time have had a real impact on life expectancy, inequalities remain, driven by smoking, obesity, and social deprivation.
The researchers wrote that combining effective disease-modifying treatments with smoking cessation, weight management, and better support for vulnerable groups could “be a practical way to reduce mortality and reduce persistent inequalities.”
“It’s encouraging to see evidence showing improvements in life expectancy for people with MS,” Godbold said. “But we need to see more consistent access to diagnosis, treatment, and support for people to manage their symptoms so that everyone with MS, no matter what their condition or where they live, can live well.”
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