Causes of death among persons with multiple sclerosis

Area of Science:

• Neurology
• Epidemiology
• Public Health

Background:

• Multiple Sclerosis (MS) is a significant cause of disability in young Americans.
• Reduced life expectancy is reported in MS patients compared to the general population.
• Underlying causes of death (UCOD) in MS are not well-characterized.

Purpose of the Study:

• To detail cause-specific mortality in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry.
• To compare mortality profiles by age, sex, race, and disability status against US mortality data.

Main Methods:

• Compared underlying cause of death (UCOD), any mention cause of death, and proportionate mortality.
• Analyzed data from US NARCOMS participants stratified by age, sex, race, and disability status.

Main Results:

• Of 32,445 participants, 2,927 had died; decedents were older, more likely male, and less educated than survivors.
• UCOD varied by age; MS as UCOD was less frequent in younger age groups (25-39) versus older (75+).
• Cancer and cardiovascular disease were more frequent causes of death with age but less than expected in older individuals; disability impact on mortality paralleled aging's effect.

Conclusions:

• Older age at enrollment, male sex, and greater disability correlate with increased mortality risk in NARCOMS participants.
• This MS cohort exhibited lower proportionate mortality from cardiovascular disease and cancer compared to the general US population.