Study Provides New Insights into MS Prevalence and Survival Rates

The prevalence of multiple sclerosis (MS) in England more than doubled over 3 decades according to a large national cohort study published in JAMA Neurology. According to investigators, this increase in prevalence likely reflects population aging, improved diagnosis, and access to specialist care. While survival rates improved over the same period, substantial disparities tied to smoking, body mass index (BMI), and socioeconomic deprivation were associated with higher mortality risk. The findings highlight modifiable lifestyle risk factors as potential targets for reducing MS-related mortality, particularly among disadvantaged populations.

Researchers used anonymized primary care records from the Clinical Practice Research Datalink (CPRD) Aurum, a nationally representative database covering approximately 24% of the English population. Individuals with MS who registered between 1990 and 2023 were identified with a validated algorithm that required at least 3 MS-coded clinical events; the index year was the first recorded MS diagnosis. The study examined trends in standardized MS prevalence, BMI, and smoking status and assessed their associations with all-cause mortality using Cox proportional hazards models. The primary analysis included 38,934 patients with an index year of 2000 or later.

Key Findings

• Age-, sex-, and region-standardized MS prevalence increased from 107.1 per 100,000 in 2000 (95% CI, 105.7-108.6) to 231.8 per 100,000 in 2020 (95% CI, 229.4-234.1), corresponding to approximately 131,000 individuals living with MS.
• Adjusted prevalence increased by 6% (95% CI, 1.06 to 1.06) annually, with prevalence 2.4 times higher (95% CI, 2.24 to 2.57) in the least deprived areas compared to the most deprived areas.
• Survival improved over time, with each later year of diagnosis associated with a 12% reduction in mortality risk (hazard ratio [HR], 0.88; 95% CI, 0.88 to 0.89; P<.001).
• Former smokers had a 44% lower mortality risk compared with current smokers (HR, 0.56; 95% CI, 0.52 to 0.61; P<.001).
• Both underweight (HR, 1.18; 95% CI, 1.03 to 1.36; P=.02) and class III obesity (HR, 1.63; 95% CI, 1.37 to 1.93; P<.001) were associated with increased mortality versus normal weight.
• Residents of the most deprived areas faced a 22% higher mortality risk compared with those in the least deprived areas (HR, 1.22; 95% CI, 1.12 to 1.32; P<.001).

Sources

Palladino R, Thompson A, Ciccarelli O. Thirty-year trends in multiple sclerosis prevalence, lifestyle factors, and mortality in England. JAMA Neurol. Published online March 23, 2026. doi:10.1001/jamaneurol.2026.0352