Impact of multiple sclerosis on life expectancy: a review

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: In recent years, increasing attention has been paid to the quality of life and life expectancy of patients with multiple sclerosis. The influence of various factors related to the disease and its course, pharmacologic treatments, and comorbid conditions on patient longevity has been actively studied, as life expectancy is considered a key indicator of therapeutic success.

AIM: Review of current data on disease duration, mortality and its causes in patients with multiple sclerosis.

METHODS: This review was based on materials from Russian and international scientific literature databases, including the electronic scientific library CyberLeninka, the Medline bibliographic database, the national electronic library eLibrary, and the abstracting and indexing databases Scopus, SpringerLink, and PubMed. Publications from the past 5–10 years were analyzed, including systematic reviews, case reports, and original research articles. The search was conducted using the following keywords: рассеянный склероз / multiple sclerosis, продолжительность жизни / life expectancy, выживаемость (survival), смертность/mortality, причины смертности / risk factors.

RESULTS: Life expectancy in patients with multiple sclerosis is reduced by approximately 6–10 years, and mortality associated with this condition is significantly higher compared with that in the general population. Individuals with multiple sclerosis demonstrate decreased overall survival and an increased risk of death from cardiovascular, respiratory, and infectious diseases, as well as from accidents and suicide.

CONCLUSION: Multiple sclerosis substantially affects life expectancy and increases the risk of premature death in patients. Long-term prognostication of disease progression remains challenging due to the limitations, fragmentation, and incompleteness of available data. Further research is needed, as identifying and understanding the risk factors for premature death are essential for ensuring timely and effective medical care throughout the course of the disease.

About the authors

Oskar V. Lyutov

Bashkir State Medical University

Email: oskar-lyutov@yandex.ru
ORCID iD: 0000-0003-1393-1122
SPIN-code: 6435-3559

Postgraduate Student

Russian Federation, Ufa

Mansur A. Kutlubaev

Bashkir State Medical University

Email: Mansur.kutlubaev@yahoo.com
ORCID iD: 0000-0003-1001-2024
SPIN-code: 4713-0312

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Ufa

Ulyana S. Kuzmina

Bashkir State Medical University

Email: ukuzmina87@gmail.com
ORCID iD: 0000-0001-7056-7895
SPIN-code: 8775-5065

Cand. Sci. (Biology), Associate Professor

Russian Federation, Ufa

Nailya F. Akhmetgaleeva

Republican Children's Clinical Hospital, Ufa

Email: nailya_9292@list.ru
ORCID iD: 0000-0003-1409-6704
SPIN-code: 7926-0260

Postgraduate Student

Russian Federation, Ufa

Yamilya A. Saitova

G.G. Kuvatov Republican Clinical Hospital

Email: yamilya.gabitova@mail.ru
ORCID iD: 0009-0000-3685-9501
SPIN-code: 7939-8229

Postgraduate Student

Russian Federation, Ufa

Klara Z. Bakhtiyarova

Bashkir State Medical University

Author for correspondence.
Email: bsmu-neuro@yandex.ru
ORCID iD: 0000-0003-0982-4324
SPIN-code: 4129-2864

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ufa

References

  1. Khabirov FA, Khaibullin TI, Akhmedova GM, et al. Multiple sclerosis: modern principles of diagnosis and treatment. Kazan: Medicine, 2017. 90 р. (In Russ.) EDN: CSKQQR
  2. Scalfari A, Knappertz V, Cutter G, et al. Mortality in patients with multiple sclerosis. Neurology. 2013;81(2):184–192. doi: 10.1212/WNL.0b013e31829a3388
  3. Leadbetter R, MacAskill M, Myall DJ, et al. Multiple sclerosis mortality in New Zealand: a nationwide prospective study. J Neurol Neurosurg Psychiatry. 2023;94(7):511–517. doi: 10.1136/jnnp-2022-330582
  4. Sandi D, Zsiros V, Füvesi J, et al. Mortality in Hungarian patients with multiple sclerosis between 1993 and 2013. J Neurol Sci. 2016;367:329–332. doi: 10.1016/j.jns.2016.06.035
  5. Boyko AN, Bakhtiyarova KZ, Sherman MA, et al. Results of a study of the quality of life in patients with highly active multiple sclerosis in Russia. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(S1):9–15. doi: 10.14412/2074-2711-2022-1S-9-15 EDN: XHANOA
  6. Sumelahti ML, Hakama M, Elovaara I, Pukkala E. Causes of death among patients with multiple sclerosis. Mult Scler. 2010;16(12):1437–1442. doi: 10.1177/1352458510379244
  7. McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325(8):765–779. doi: 10.1001/jama.2020.26858
  8. Lunde HMB, Assmus J, Myhr KM, et al. Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study. J Neurol Neurosurg Psychiatry. 2017;88(8):621–625. doi: 10.1136/jnnp-2016-315238
  9. Smyrke N, Dunn N, Murley C, Mason D. Standardized mortality ratios in multiple sclerosis: Systematic review with meta-analysis. Acta Neurol Scand. 2022;145(3):360–370. doi: 10.1111/ane.13559
  10. Marrie RA, Elliott L, Marriott J, et al. Effect of comorbidity on mortality in multiple sclerosis. Neurology. 2015;85(3):240–247. doi: 10.1212/WNL.0000000000001718
  11. Kingwell E, Zhu F, Evans C, et al. Causes that contribute to the excess mortality risk in multiple sclerosis: a population-based study. Neuroepidemiology. 2020;54(2):131–139. doi: 10.1159/000504804
  12. Foulon S, Maura G, Dalichampt M, et al. Prevalence and mortality of patients with multiple sclerosis in France in 2012: a study based on French health insurance data. J Neurol. 2017;264(6):1185–1192. doi: 10.1007/s00415-017-8513-0
  13. Leray E, Moreau T, Fromont A, et al. Epidemiology of multiple sclerosis. Rev Neurol. 2016;172(1):3–13. doi: 10.1016/j.neurol.2015.10.006
  14. Rodríguez-Antigüedad ZA, Mendibe BM, Llarena GC, et al. Mortality and cause of death in multiple sclerosis: findings from a prospective population-based cohort in Bizkaia, Basque Country, Spain. Neuroepidemiology. 2014;42(4):219–225. doi: 10.1159/000359971
  15. Bezzini D, Kundisova L, Gori F, et al. Mortality trend for multiple sclerosis in Italy during the period 1980–2015. Mult Scler Relat Disord. 2020;44:102240. doi: 10.1016/j.msard.2020.102240
  16. Willumsen JS, Grytten N, Aarseth J, et al. Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study. J Neurol Neurosurg Psychiatry. 2022;93(11):1154–1161. doi: 10.1136/jnnp-2022-329169
  17. Koch-Henriksen N, Laursen B, Stenager E, Magyari M. Excess mortality among patients with multiple sclerosis in Denmark has dropped significantly over the past six decades: a population based study. J Neurol Neurosurg Psychiatry. 2017;88(8):626–631. doi: 10.1136/jnnp-2017-315907
  18. Hirst C, Swingler R, Compston DA, et al. Survival and cause of death in multiple sclerosis: a prospective population-based study. J Neurol Neurosurg Psychiatry. 2008;79(9):1016–1021. doi: 10.1136/jnnp.2007.127332
  19. Harding K, Anderson V, Williams O, et al. A contemporary study of mortality in the multiple sclerosis population of south east Wales. Mult Scler Relat Disord. 2018;25:186–191. doi: 10.1016/j.msard.2018.08.001
  20. Walz L, Brooks JC, Shavelle RM, et al. Life expectancy in multiple sclerosis by EDSS score. Mult Scler Relat Disord. 2022;68:104219. doi: 10.1016/j.msard.2022.104219
  21. Suslina ZA, Zakharova MN, Zavalishin IA, et al. Protocol for patients' management "disseminated sclerosis". Health care Standardization Problems. 2006;(2):25–97. EDN: JUQLKN
  22. Boyko AN, Kukel TM, Lysenko MA, et al. Clinical epidemiology of multiple sclerosis in Moscow. Сlinical demo-graphic characteristics in population of one region of Moscow. S.S. Korsakov Journal of Neurology and Psychiatry. 2014;114(2-2):10–15. EDN: RZQLBJ
  23. Laffaldano P, Lucisano G, Manni A, et al. Risk of getting COVID-19 in people with multiple sclerosis: a case-control study. Neurol Neuroimmunol Neuroinflamm. 2022;9(2):e1141. doi: 10.1212/NXI.0000000000001141
  24. Rollot F, Fauvernier M, Uhry Z, et al. Effects of age and disease duration on excess mortality in patients with multiple sclerosis from a French nationwide cohort. Neurology. 2021;97(4):e403–e413. doi: 10.1212/WNL.0000000000012224
  25. Grytten N, Myhr KM, Celius EG, et al. Cancer related mortality in multiple sclerosis. A population based cohort study. Mult Scler Relat Disord. 2023;69:104417. doi: 10.1016/j.msard.2022.104417
  26. Calocer F, Ng HS, Zhu F, et al. Low socioeconomic status was associated with a higher mortality risk in multiple sclerosis. Mult Scler. 2023;29(3):466–470. doi: 10.1177/13524585221129963
  27. Graves JS, Krysko KM, Hua LH, et al. Ageing and multiple sclerosis. Lancet Neurol. 2023;22(1):66–77. doi: 10.1016/S1474-4422(22)00184-3
  28. Edwards NC, Munsell M, Menzin J, et al. Comorbidity in US patients with multiple sclerosis. PROM. 2018;9:97–102. doi: 10.2147/PROM.S148387
  29. Feinstein A, Pavisian B. Multiple sclerosis and suicide. Mult Scler. 2017;23(7):923–927. doi: 10.1177/1352458517702553
  30. Kalb R, Feinstein A, Rohrig A, et al. Depression and suicidality in multiple sclerosis: red flags, management strategies, and ethical considerations. Curr Neurol Neurosci Rep. 2019;19(10):77. doi: 10.1007/s11910-019-0992-1
  31. Mosolov SN, Parfenov VA, Amelin AV, et al. Depressive disorders and their pharmacotherapy in routine clinical practice. Neurology, Neuropsychiatry, Psychosomatics. 2023;15(5):54–64. doi: 10.14412/2074-2711-2023-5-54-64 EDN: RPPWKW
  32. Brenner P, Burkill S, Jokinen J, et al. Multiple sclerosis and risk of attempted and completed suicide — a cohort study. Eur J Neurol. 2016;23(8):1329–1336. doi: 10.1111/ene.13029
  33. Jakimovski D, Guan Y, Ramanathan M, et al. Lifestyle-based modifiable risk factors in multiple sclerosis: review of experimental and clinical findings. Neurodegener Dis Manag. 2019;9(3):149–172. doi: 10.2217/nmt-2018-0046
  34. Sharafutdinova LR, Magzhanov RV, Rakhmatullin AR, Bakhtiiarova K.Z. Smoking as a risk factor of development and progression of multiple sclerosis (a review and experimental data). S.S. Korsakov Journal of Neurology and Psychiatry. 2013;113(10-2):18–22. EDN: RTEKQX
  35. Palladino R, Marrie RA, Majeed A, Chataway J. Evaluating the risk of macrovascular events and mortality among people with multiple sclerosis in England. JAMA Neurol. 2020;77(7):820. doi: 10.1001/jamaneurol.2020.0664
  36. Sivertseva SA, Lashch NY, Zotova AV, et al. A role of cerebrovascular diseases in the progression of multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(5):53–57. doi: 10.17116/jnevro202412405153 EDN: AZQCYM
  37. Fedeli U, Barbiellini AC, Avossa F, et al. Association of multiple-sclerosis-related mortality with COVID-19 and other common infections: a multiple causes of death analysis. Euro J Neurology. 2023;30(9):2870–2873. doi: 10.1111/ene.15912
  38. Bsteh G, Bitschnau C, Hegen H, et al. Multiple sclerosis and COVID-19: How many are at risk? Euro J Neurology. 2021;28(10):3369–3374. doi: 10.1111/ene.14555
  39. Hadidchi R, Wang SH, Rezko D, et al. SARS-CoV-2 infection increases long-term multiple sclerosis disease activity and all-cause mortality in an underserved inner-city population. Mult Scler Relat Disord. 2024;86:105613. doi: 10.1016/j.msard.2024.105613
  40. Fuchs TA, Wattengel BA, Carter MT, et al. Outcomes of multiple sclerosis patients admitted with COVID-19 in a large veteran cohort. Mult Scler Relat Disord. 2022;64:103964. doi: 10.1016/j.msard.2022.103964
  41. Bsteh G, Assar H, Hegen H, et al. COVID-19 severity and mortality in multiple sclerosis are not associated with immunotherapy: Insights from a nation-wide Austrian registry. PLoS ONE. 2021;16(7):e0255316. doi: 10.1371/journal.pone.0255316
  42. Louapre C, Collongues N, Stankoff B, et al. Clinical characteristics and outcomes in patients with coronavirus disease 2019 and multiple sclerosis. JAMA Neurol. 2020;77(9):1079–1088. doi: 10.1001/jamaneurol.2020.2581
  43. Kuzmina USh, Tukhvatullin AV, Lyutov OV, et al. A case of COVID-associated encephalopathy in a patient with multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(4):159–163. doi: 10.17116/jnevro2024124041159 EDN: XXABZC
  44. Chalmer TA, Baggesen LM, Nørgaard M, et al. Early versus later treatment start in multiple sclerosis: a register-based cohort study. Euro J Neurol. 2018;25(10):1262–е110. doi: 10.1111/ene.13692
  45. Kingwell E, Leray E, Zhu F, et al. Multiple sclerosis: effect of beta interferon treatment on survival. Brain. 2019;142(5):1324–1333. doi: 10.1093/brain/awz055
  46. Khabirov FA, Khaybullin TI, Granatov EV, et al. Multiple sclerosis in the Republic of Tatarstan: epidemiological and clinical characteristics. Practical Medicine. 2020;18(5):50–57. doi: 10.32000/2072-1757-2020-5-50-57 EDN: DVTHND
  47. GBD 2016 Multiple Sclerosis Collaborators. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurology. 2019;18(3):269–285. doi: 10.1016/S1474-4422(18)30443-5
  48. Boytsov SA, Deev AD, Shalnova SA. Mortality and risk factors for non-communicable diseases in Russia: specific features, trends, and prognosis. Terapevticheskii Arkhiv. 2017;89(1):5–13. doi: 10.17116/terarkh20178915-13 EDN: XXELIF

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».