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Multiple sclerosis and mortality statistics
Abstract:
We have previously found a 3-fold increase in prevalence and a corresponding increase in incidence of multiple sclerosis (MS) from 1963 to 1983 in the county of Hordaland, Norway. When studying the official mortality statistics and the deceased patients in our clinical MS-material, no increase in death rate could be observed in the same period. We also found that official mortality statistics include both over- and underestimates of MS-patients. Of definite MS-patients in the clinical material, 91.7% were registered with MS on the death certificates, either as underlying or contributory cause of death. When studying only underlying cause of death, we found that 59.5% of deceased definite MS patients were registered as MS on the death certificates. This study shows that official mortality statistics reflect a change in incidence of MS both incompletely and with a delay of several decades.
Insights
Official mortality statistics do not accurately reflect multiple sclerosis (MS) incidence changes. MS patient registration on death certificates is incomplete and delayed, leading to underestimates in mortality data.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Previous research indicated a threefold increase in multiple sclerosis (MS) prevalence and incidence in Hordaland, Norway, between 1963 and 1983.
- However, official mortality statistics from the same period did not show a corresponding rise in the MS death rate.
Purpose of the Study:
- To investigate the accuracy of official mortality statistics in reflecting changes in multiple sclerosis (MS) incidence.
- To assess the completeness and timeliness of MS patient registration on death certificates.
Main Methods:
- Comparison of clinical MS patient data with official mortality records in Hordaland, Norway.
- Analysis of death certificates to determine the proportion of definite MS patients registered with MS as an underlying or contributory cause of death.
Main Results:
- Official mortality statistics underestimated MS patient numbers and did not capture the observed increase in MS incidence.
- 91.7% of definite MS patients in the clinical material were registered with MS on death certificates (underlying or contributory cause).
- Only 59.5% of deceased definite MS patients were registered with MS as the underlying cause of death.
Conclusions:
- Official mortality statistics provide an incomplete and delayed reflection of changes in multiple sclerosis (MS) incidence.
- There are significant discrepancies in the registration of MS as a cause of death, impacting the reliability of mortality data for epidemiological studies.