Multiple sclerosis mortality trends in Spain from 1981 to 2020

Area of Science:

• Epidemiology
• Public Health
• Neurology

Background:

• Multiple sclerosis (MS) is a chronic neurological disease with significant public health implications.
• Understanding temporal trends in MS mortality is crucial for resource allocation and public health interventions.
• Previous studies on MS mortality trends have shown varying patterns across different populations.

Purpose of the Study:

• To analyze time trends in multiple sclerosis (MS) mortality within the Spanish population from 1981 to 2020.
• To investigate the independent effects of gender, age, period, and birth cohort on MS mortality trends.
• To provide insights into the changing epidemiology of MS mortality in Spain.

Main Methods:

• Utilized data on MS deaths and population statistics from Spain's National Institute of Statistics.
• Calculated age-standardized mortality rates (ASMR) and performed trend analyses using joinpoint regression software.
• Employed Age-Period-Cohort (APC) analysis via a US National Cancer Institute web tool to explore underlying mortality drivers.

Main Results:

• Age-standardized mortality rates (ASMR) for MS demonstrated a significant increase in both women (1.7% annually) and men (1.2% annually).
• Joinpoint analysis revealed stable MS mortality rates in men from 1981-2000, followed by a significant increase (2.6% annually) from 2000-2020; no trend change was detected for women.
• APC analysis indicated a steady increase in period effects for both sexes since the 1990s and identified a birth cohort-related increase in mortality, peaking for women born around 1956 and men around 1966.

Conclusions:

• MS mortality rates have steadily increased in Spain over recent decades, with a more pronounced rise observed in men.
• The identified birth cohort patterns in MS mortality, showing decreasing risk for more recent cohorts, align with findings from international studies.
• These trends underscore the need for continued epidemiological surveillance and research into the factors influencing MS mortality.