Dementia risk significantly higher for people with MS: Meta-analysis
Prevalence of dementia found particularly high in studies in U.S., in older people
People with multiple sclerosis (MS) have a significantly greater risk of developing dementia compared with the general population, according to a new systematic review and meta-analysis.
Of nearly 38,000 MS patients assessed across 10 published studies, about 5% had a diagnosis of dementia. The prevalence was particularly high in studies in the U.S., where 15.51% of patients had dementia, and in older people.
“The increased prevalence in specific subgroups, particularly older individuals and those in certain regions, underscores the need for targeted cognitive screening and the implementation of standardized diagnostic protocols in clinical settings,” researchers wrote.
The study, “Dementia in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis,” was published in Brain and Behavior.
MS is a progressive neurodegenerative disease in which damage to the brain and spinal cord leads to a variety of symptoms, including difficulty moving and cognitive impairment.
30%-70% of MS patients experience cognitive problems
About 30%-70% of patients experience problems with cognition. These issues are often mild, but some people have cognitive decline severe enough to interfere with everyday life, in which case they are diagnosed with dementia.
Dementia may arise from the biological processes underlying MS and from other processes that occur with aging. With the increased life expectancy in people with MS, it is important to determine how many patients are living with dementia to help healthcare providers address it more adequately.
To know more, a group of researchers in Iran conducted a review of published studies that had assessed the prevalence and risk of dementia in people with MS. A total of 10 studies, published from 1994 to 2024 and involving a total of 37,831 patients, were included in the analysis.
Pooled results from all 10 studies showed 5.31% of patients had been diagnosed with dementia. The risk of MS patients being diagnosed with dementia is 67% higher compared with the general population, according to a meta-analysis of four studies that reported on dementia risk.
Two studies examined the risk of Alzheimer’s disease specifically. While a meta-analysis was not conducted due to the limited number of studies, these showed MS more than doubled the risk of Alzheimer’s across all ages. For an early-onset form of Alzheimer’s, MS increased the risk by 4.49%.
A number of factors seemed to impact the overall prevalence of dementia. For example, dementia was found most common in studies conducted in America (15.51% vs. 4.18% in Asia and 1.49% in Europe), and in studies that included participants older than 50 years (11.63% vs. 4.05% for studies including younger participants).
“Lower prevalence estimates reported in studies from other continents may reflect underdiagnosis, differences in MS disease progression, or methodological inconsistencies across investigations,” the team wrote. “The considerable variability across studies indicates that these estimates should be interpreted with caution, as inconsistencies in research approaches may have influenced the results.”
While more research is needed to better establish risk of dementia among MS patients, the high incidence reported in this study highlights the need for increasing vigilance to identify dementia in this population, according to the researchers.
“Routine cognitive screening, especially as patients age, could facilitate early detection,” they wrote.
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