MS causing fewer deaths, less disability than in the past: Study
Global burden of disease expected to keep falling through 2040
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Three people sit at a table looking at graphs and charts.
- The global burden of multiple sclerosis (deaths, disability) has decreased since 1990 and is projected to continue falling.
- This decline is attributed to improved MS care, and comes despite an increase in total cases driven by population growth.
- Equitable access to diagnosis, treatment, and rehabilitation, and addressing risk factors like smoking remain crucial.
Although the total number of people living with multiple sclerosis (MS) has increased globally in recent decades due to population growth and aging, MS is causing fewer deaths and less disability now than in the past, according to a new study.
Predictions also suggest that this trend toward reduced disease burden will likely continue in the coming years.
“The global burden of MS has declined from 1990 to 2021 in terms of age-standardized rates,” researchers wrote. “Projections suggest a continued decrease in disease burden through 2040; however, challenges related to healthcare accessibility, long-term disability management, and equitable resource allocation remain.”
The study, “Global, Regional, and National Burden of Multiple Sclerosis from 1990 to 2021 and Projections to 2040: A Comprehensive Analysis from the Global Burden of Disease Study,” was published in Multiple Sclerosis and Related Disorders.
Increase in MS incidence attributable to population growth, longevity
MS is a chronic disorder marked by inflammation that damages the brain and spinal cord, leading to symptoms such as fatigue, mobility issues, and mental health challenges. These symptoms can be disabling, and although MS itself is generally not considered fatal, it can increase the risk of infections and other potentially life-threatening complications.
The Global Burden of Disease Study is a worldwide research program that tracks morbidity and mortality related to serious diseases. Using data from this study, scientists in China evaluated how the worldwide impact of MS changed between 1990 and 2021.
“This study provides an overview of the global, regional, and national burden of MS from 1990 to 2021, examining trends in incidence, deaths, and [disability], as well as disparities by SDI, sex, and age,” the researchers wrote. The SDI, or sociodemographic index, is a metric that assesses such factors as income and education to evaluate socioeconomic conditions.
The findings revealed that, over the past three decades, the number of people diagnosed with MS each year has increased worldwide, from nearly 42,000 new cases in 1990 to almost 63,000 new cases in 2021.
But this increase in MS incidence was largely explained by the fact that the total number of people on earth has increased, and that people are living longer now than they did 30 years ago. After accounting for population and age, rates of MS were relatively stable over time.
Improvements in MS care drive decrease in death, disease burden rates
Data also showed that total deaths and DALYs attributable to MS also increased over the last three decades. DALYs is a measure of overall disease burden that reflects the total amount of healthy life lost due to premature death or some degree of disability.
But again, this was mainly because the population as a whole is growing and living longer. After adjusting for age, the researchers found that rates of deaths and DALYs attributed to MS have actually decreased over the past three decades.
This decrease is likely driven by improvements in MS care in recent decades, the scientists said. Their models also predicted that this decrease will continue through at least 2040.
These findings underscore the need for targeted public health strategies, including early diagnosis, accessible and equitable treatment, comprehensive rehabilitation services, and preventive measures such as smoking cessation.
Data also showed that rates of MS, deaths, and DALYs related to MS were all consistently higher in nations with higher SDI scores (indicating wealthier socioeconomic status). This is likely because many MS patients in poorer regions of the world do not get an accurate diagnosis or receive appropriate care, the researchers said.
“Despite increasing awareness and advances in diagnosis and treatment, many low- to middle-SDI countries still face diagnostic delays and limited access to care, and limited rehabilitation resources. These disparities suggest that the global burden of MS is not solely attributable to sociodemographic differences, but also reflects uneven access to diagnosis, treatment, and rehabilitation,” the researchers wrote.
These data highlight a need for continued efforts to address disparities in MS care. Of note, the analyses indicated that improvements in SDI within a country don’t necessarily translate into lower MS burden, so addressing these disparities won’t be as simple as building up developing economies. Deliberate efforts to invest in healthcare systems and to improve MS care specifically are likely needed to reduce the MS burden.
The scientists also highlighted a need for more efforts to reduce environmental MS risk factors. In particular, smoking remained a key factor contributing to MS deaths and DALYs over time, so efforts to reduce smoking may help reduce the global burden of this disease.
“These findings underscore the need for targeted public health strategies, including early diagnosis, accessible and equitable treatment, comprehensive rehabilitation services, and preventive measures such as smoking cessation,” the researchers concluded.
