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Mortality of multiple sclerosis in Iceland population-based mortality of MS in incidence and prevalence cohorts
Olöf Eliasdottir1,2, Ólafur Kjartansson3, Elias Olafsson4,5
1Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Introduction:
Mortality is an important feature of the natural history of multiple sclerosis (MS). We report the mortality of all individuals with MS in Iceland, identified in a nationwide population-based study.
Patients And Methods:
The results are based on a prevalence cohort and an incidence cohort. The prevalence cohort consisted of all patients with MS (n = 526) living in Iceland on the 31 December 2007. The incidence cohort consisted of all residents of Iceland (n = 222) diagnosed with MS during 2002 to 2007. Mortality was determined by following both the incidence cohort (from diagnosis) and the prevalence cohort (from the prevalence day) until death or 31 December 2020. The mortality, associated with MS, was compared with that expected in the Icelandic population (standardized mortality ratio (SMR)).
Results:
(a) Prevalence cohort (n = 526). The mean follow up was 12.0 years (range 0.3-13.0). The SMR was 1.6 (95% confidence interval (CI) 1.3-2.0). (b) Incidence cohort (n = 222). The mean follow up was 15.4 years (range 3.7-18.5). The SMR was 1.2 (95% CI 0.6-2.2).
Conclusion:
During the follow-up period, there was a substantial increase in mortality among the patients with MS, compared with the general population. There was no increase in mortality among the incidence cohort, when followed for up to 18.5 years following diagnosis.
Insights
Mortality in multiple sclerosis (MS) patients in Iceland was higher than the general population. However, no increased mortality was observed in those diagnosed with MS between 2002-2007, even after 18.5 years.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Mortality is a critical aspect of multiple sclerosis (MS) natural history.
- Understanding MS-related mortality trends is vital for patient care and public health strategies.
Purpose of the Study:
- To investigate and report the mortality rates of individuals with MS in Iceland.
- To compare MS patient mortality with the general Icelandic population using a nationwide study.
Main Methods:
- Utilized a prevalence cohort (n=526) and an incidence cohort (n=222) of MS patients in Iceland.
- Followed cohorts from 2007 (prevalence) or diagnosis (incidence) until December 2020.
- Calculated standardized mortality ratios (SMR) to compare MS mortality with the general population.
Main Results:
- The prevalence cohort showed a significantly increased mortality, with an SMR of 1.6 (95% CI 1.3-2.0).
- The incidence cohort did not demonstrate a statistically significant increase in mortality, with an SMR of 1.2 (95% CI 0.6-2.2).
Conclusions:
- A substantial increase in mortality was observed among MS patients compared to the general population.
- No elevated mortality risk was found in the incidence cohort up to 18.5 years post-diagnosis.
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