MS cases double in England over 20 years; life expectancy rises
Study notes advances in diagnosis, but social inequalities persist
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A hand in a medical glove fist bumps another hand.
- MS cases doubled in England over 20 years, but life expectancy improved due to better care and diagnosis.
- Social inequalities persist; deprived areas show higher mortality, linked to obesity and smoking.
- Tackling smoking, obesity, and improving access to care can reduce deaths and health disparities.
Multiple sclerosis (MS) has become far more common in England over the past two decades, but people diagnosed more recently are living longer, according to a study led by University College London (UCL).
The shift reflects major advances in MS diagnosis and care. But researchers found that social inequalities still increase risks for many, with more deprived regions having higher rates of obesity and smoking as well as higher mortality rates.
“People with MS are living longer than ever before, thanks to better care, disease-modifying therapies, and earlier diagnosis, but there is still much more to do,” Olga Ciccarelli, PhD, a research professor at UCL, said in a university press release. “Tackling smoking, obesity, and inequalities in access to diagnostics and care could reduce avoidable deaths and help people with MS stay healthier for longer.”
The study, “Thirty-Year Trends in Multiple Sclerosis Prevalence, Lifestyle Factors, and Mortality in England,” was published as a research letter in JAMA Neurology.
In MS, the immune system attacks the central nervous system, which includes the brain and spinal cord. This can cause symptoms such as tingling, numbness, limb weakness, and vision loss.
MS care has changed substantially in recent decades, with earlier diagnosis, wider use of disease-modifying therapies, and growing efforts to address lifestyle factors such as smoking and obesity. However, it has remained unclear how these changes have reshaped the overall MS landscape at the population level — particularly in terms of prevalence (number of new cases), survival, and the impact of socioeconomic deprivation.
30 years of data show trends
The UCL researchers analyzed 30 years of data from a large database of primary care records covering nearly one-quarter of the English population.
The results showed that the number of people living with MS rose from 21,997 in 2000 to 37,669 in 2020. After adjusting for age, sex, and region, the researchers estimated that about 107 per 100,000 people were living with the condition in 2000, but this number more than doubled to 232 per 100,000 in 2020. This corresponds to about 131,000 people living with MS in England in 2020.
On average, prevalence increased by 6% each year. Assuming the trend has continued over time, the researchers estimated that about 190,000 people in the country are currently living with MS.
While MS prevalence increased, survival improved. People diagnosed after 2000 were more likely to live to age 80 than the overall group (43.8% vs. 34.5%), and mortality rates fell by about 12% with each later year of diagnosis.
The researchers also identified some inequalities. For example, while prevalence was higher in wealthier areas, mortality 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 treatments.
People living in deprived areas were also more likely to smoke or be obese, both of which were associated with worse outcomes.
Indeed, smoking and obesity were consistently linked to shorter survival, while quitting smoking was associated with better outcomes. These lifestyle factors may partly explain the disparities seen across socioeconomic groups.
“We know smoking and obesity can worsen MS, and this study suggests targeted support around stopping smoking and maintaining a healthy weight could also be crucial in reducing inequalities in MS outcomes,” said Catherine Godbold, PhD, senior research communications manager at the MS Society U.K., which partly supported the study.
The findings overall show that while advances in healthcare over time have had a real impact on life expectancy, inequalities remain, driven by smoking, obesity, and social deprivation.
Combining effective disease-modifying therapies with smoking cessation, weight management, and better support for disadvantaged groups may represent “a pragmatic route to reducing mortality rates and narrowing persistent inequalities,” the researchers wrote.
“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, whatever their circumstances or where they live, can live well.”
