An analysis of more than 42,000 deaths in the United States related to multiple sclerosis (MS) found that mortality rates varied by age, region, race, and ethnicity, with black patients dying younger than white patients and high blood pressure contributing to the increase. Research results just published in the journal Neurologypoints out the need for timely diagnosis and better prevention strategies to extend the lifespan of MS patients.
MS is a chronic disease that damages the brain and spinal cord, causing symptoms such as vision problems, muscle weakness, and fatigue. People with MS have a shorter life expectancy than the general population, but the disease affects each person differently.
“Questions remain about how factors such as access to health care, comorbid health conditions, and demographic characteristics influence a person’s risk of death,” said Liliana Amezcua, MD, PhD, associate professor of neurology and chief of the neuroimmunology and multiple sclerosis division at the Keck School of Medicine at the University of Southern California, who led the study.
Overall, the researchers found that mortality rates for MS patients increased over the 12 years analyzed, even when comparing people in the same age group.
Although it is anticipated that advances in treatments for MS may flatten these trends over time, mortality rates continue to increase. This shows that there is still work to be done, especially when it comes to managing other health conditions that affect people with MS. ”
Liliana Amezcua, MD, Associate Professor of Neurology and Head of the Division of Neuroimmunology and Multiple Sclerosis, Keck School of Medicine, University of Southern California
Difference in mortality rate
To learn more about MS mortality, Amezcua and colleagues from the University of Kentucky and the University of Virginia analyzed 42,205 death certificates from the Centers for Disease Control and Prevention’s Widespread Online Data for Epidemiological Research (WONDER) database. The study included deaths from 2012 to 2023 in the continental United States where MS was listed as the underlying cause.
The researchers then looked at how mortality rates varied by age, sex, race, and ethnicity. They found that black people had the highest MS-related death rates, followed by white people, and other races had lower death rates. Black patients with MS tended to die younger, with peak mortality rates between ages 65 and 74, while white patients were most likely to die between ages 75 and 84. In the Hispanic population, mortality among female patients increased between ages 45 and 84.
The researchers then collected data on co-occurring health conditions from each death certificate and found that MS-related deaths with high blood pressure increased from 2019 to 2023, especially among whites and blacks. MS-related deaths involving cardiac arrest also increased from 2019 to 2022, particularly among Black patients.
The study also revealed geographic differences in MS mortality. The highest rates were concentrated in parts of the northern and midwestern United States (Wyoming, Oregon, Utah, Nebraska, Kansas, Minnesota, Michigan, New Hampshire, and Maine). MS is known to be more common in northern regions, but researchers say access to health care, demographics and other factors may also help explain these patterns.
Because the study relied on death certificates, researchers were unable to account for factors such as MS severity, treatment, and access to medical care. They also note that the COVID-19 pandemic may have influenced mortality trends in the final year of the study.
Co-occurring health conditions
An important takeaway from this study is that co-morbid conditions, particularly cardiovascular disease, are associated with worse long-term outcomes in MS patients.
“Many of these conditions are preventable or treatable,” Amezcua says. “It is important to provide comprehensive care that considers a person’s entire health, rather than just focusing on multiple sclerosis.”
Amezcua said co-occurring symptoms may also contribute to delays in MS diagnosis. For example, damage caused by cardiovascular disease can resemble MS on brain scans, making it more difficult to distinguish between the two conditions. Advances in brain imaging technology may allow doctors to diagnose MS earlier and more accurately.
The research team is currently studying why some MS patients are diagnosed later than others. Previous studies have found that patients from racial and ethnic minorities may wait up to 10 years longer for an MS diagnosis than white patients, potentially delaying timely treatment.
sauce:
Keck School of Medicine, University of Southern California
Reference magazines:
Amezcua, L. others. (2026). Racial and ethnic trends and comorbidity patterns in multiple sclerosis mortality. neurology open access. DOI: 10.1212/wn9.0000000000000148. https://www.neurology.org/doi/10.1212/WN9.0000000000000148
