Journal Mobile Options
Table of Contents
Vol. 26, No. 2, 2006
Issue release date: February 2006
Neuroepidemiology 2006;26:102–107

Multiple Sclerosis Mortality and Patterns of Comorbidity in the United States from 1990 to 2001

Redelings M.D. · McCoy L. · Sorvillo F.
aLos Angeles County Department of Health Services, and bDepartment of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, Calif., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Multiple sclerosis (MS) is a neurodegenerative condition that can result in cognitive and physical disability and shortened life expectancy. However, population-based information is lacking regarding the mortality burden from MS in the United States. We investigated trends in MS mortality rates and examined important comorbidities in the United States from 1990 to 2001. MS deaths were matched by age, sex, and race/ethnicity with randomly selected deaths from other conditions for matched odds ratio comparisons. The overall age-adjusted mortality rate from MS was 1.44/100,000 population. MS mortality rates increased throughout the study period. MS mortality rates were higher in whites than in any other racial/ethnic group, followed by Blacks, Hispanics, American Indians/Alaska Natives, and Asians and Pacific Islanders. Observed mortality rates were more than 10 times lower in Asians and Pacific Islanders than in whites. The odds of pressure ulcers, urinary tract infections, and pneumonia/influenza being reported on the death certificate were higher in MS deaths than in matched controls.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Fraser C, Strak S: Cognitive symptoms and correlates of physical disability in individuals with multiple sclerosis. J Neurosci Nurs 2003;35:314–320.

    External Resources

  2. Pittock SJ, Mayr WT, McClelland RL, Jorgensen BS, Weigand SD, Noseworthy JH, Weinshenker BG, Rodriguez M: Change in MS-related disability in a population-based cohort. A 10-year follow-up study. Neurology 2004;62:51–59.
  3. Patten SB, Beck CA, Williams JVA, Barbui C, Metz LM: Major depression in multiple sclerosis. A population-based perspective. Neurology 2003;61:1524–1527.
  4. Walsh SJ, DeChello LM: Excess autoimmune disease mortality among school teachers. J Rheumatol 2001;28:1537–1545.
  5. Sadovnick AD, Ebers GC, Wilson RW, Paty DW: Life expectancy in patients attending multiple sclerosis clinics. Neurology 1992;42:991–994.
  6. Jacobsen DL, Gange SH, Rose NR, Graham NMH: Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 1997;84:223–243.
  7. Cooper GS, Stroehla BC: The epidemiology of autoimmune diseases. Autoimmun Rev 2003;2:119–125.
  8. Noonan CW, Kathman SJ, White MC: Prevalence estimates for MS in the United States and evidence for an increasing trend for women. Neurology 2002;58:136–138.
  9. Kalman B, Albert RH, Leist TP: Genetics of multiple sclerosis: determinants of autoimmunity and neurodegeneration. Autoimmunity 2002;35:225–234.
  10. Compston A, Coles A: Multiple sclerosis. Lancet 2002;359:1221–1231.
  11. Van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Simmons R, Taylor BV, Butzkueven H, Kilpatrick T: Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ 2003;327:316–321.
  12. Hayes CE: Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc 2000;59:531–535.
  13. Granieri E, Cassetta I, Tola MR, Ferrante P: Multiple sclerosis: infectious hypothesis. Neurol Sci 2001;22:179–185.
  14. Hernan MA, Oleky MJ, Ascherio A: Cigarette smoking and incidence of multiple sclerosis. Am J Epidemiol 2001;154:69–74.
  15. Riise T, Moen BE, Kyvik KR: Organic solvents and the risk of multiple sclerosis. Epidemiology 2002;13:718–720.
  16. Malosse D, Perron H: Correlation analysis between bovine populations, other farm animals, house pets, and multiple sclerosis prevalence. Neuroepidemiology 1993;12:15–27.
  17. Lilienfeld DE, Perl DP: Projected neurodegenerative disease mortality in the United States, 1990–2040. Neuroepidemiology 1993;12:219–228.
  18. National Center for Health Statistics (1997–2004): Data File Documentations, Multiple Cause-of-Death, 1990–2001 (machine readable data file and documentation, CD-ROM Series 20), Hyattsville, National Center for Health Statistics.
  19. International Classification of Diseases, 9th Revision. Geneva, World Health Organization, 1980.
  20. International Classification of Diseases, 10th Revision. Geneva, World Health Organization, 1992.
  21. National Center for Health Statistics: Bridged-race intercensal estimates of the July 1, 1990–July 1, 1999, United States resident population by county, single-year of age, sex, race, and Hispanic origin, prepared by the U.S. Census Bureau with support from the National Cancer Institute.
  22. National Center for Health Statistics: Estimates of the July 1, 2000–July 1, 2002, United States resident population from the Vintage 2002 postcensal series by year, county, age, sex, race, and Hispanic origin, prepared under a collaborative arrangement with the U.S. Census Bureau.
  23. Ingram DD, Parker JD, Schenker N, Weed JA, Hamilton B, Arias E, Madans JH: United States Census 2000 population with bridged race categories. National Center for Health Statistics. Vital Health Stat 2. 2003.
  24. Anderson RN, Rosenberg HM: Age standardization of death rates: implementation of the Year 2000 Standard. Nat Vital Stat Rep 1998;47:1–9.
  25. National Center for Health Statistics. Health, United States, 2004. With chartbook on trends in the Americas. Hyattsville, National Center for Health Statistics, 2004.
  26. Lai SM, Zhang ZX, Alter M, Sobel E: World-wide trends in multiple sclerosis mortality. Neuroepidemiology 1989;8:56–67.
  27. Rodriguez M, Siva A, Ward J, Stolp-Smith K, O’Brien P, Kurland L: Impairment, disability, and handicap in multiple sclerosis: a population-based study in Olmsted County, Minnesota. Neurology 1994;44:28–33.
  28. Hoffman RE, Zack MM, Davis LE, Bruchfiel CM: Increased incidence and prevalence of multiple sclerosis in Los Alamos County, New Mexico. Neurology 1991;31:1489–1492.
  29. Nelson LM, Hamman RF, Thompson DS, Baum HM, Boteler DL, Burks JS, Franklin GM: Higher than expected prevalence of multiple sclerosis in Northern Colorado: dependence on methodologic issues. Neuroepidemiology 1986;5:17–28.
  30. Wallin MT, Page WF, Kurtzke JF: Multiple sclerosis in US veterans of the Vietnam era and later military service: race, sex, and geography. Ann Neurol 2004;55:65–71.
  31. Tsai CP, Yuan CL, Yu HY, Chen C, Guo YC, Shan DE: Multiple sclerosis in Taiwan. J Chin Med Assoc 2004;67:500–505.

    External Resources

  32. Houzen H, Niino M, Kikuchi S, et al: The prevalence and clinical characteristics of MS in northern Japan. J Neurol Sci 2003;211:49–53.
  33. Singhal BS: Multiple sclerosis – Indian experience. Ann Acad Med Singapore 1985;14:32–36.
  34. Yu YL, Woo E, Hawkins BR, Ho HC, Huang CY: Multiple sclerosis amongst Chinese in Hong Kong. Brain 1989;112:1445–1467.
  35. Fleming ST, Blake RL Jr: Patterns of comorbidity in elderly patients with multiple sclerosis. J Clin Epidemiol 1994;47:1127–1132.
  36. Foster HE: Urinary tract infections (UTIs) and multiple sclerosis: connection between UTIs and neurological progression? Mult Scler Quart Rep 2002;21:1–4.
  37. Parker LJ: Urinary catheter management: minimizing the risk of infection. Br J Nurs 1999;8:563–566, 568, 570.
  38. Sedor J, Mulholland SG: Hospital-acquired urinary tract infections associated with the indwelling catheter. Urol Clin North Am 1999;26:821–828.
  39. Myers LW: Immunologic therapy for secondary and primary progressive multiple sclerosis. Curr Neurol Neurosci Rep 2001;1:286–293.
  40. Bridges CB, Fukuda K, Uyeki TM, Cox NJ, Singleton JA: Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep 2002;51(RR-3):1–36.
  41. Miller AE, Morgante LA, Buchwald LY, Nutile SM, Coyle PK, Krupp LB, Doscher CA, Lublin FD, Knobler RL, Trantas F, Kelley L, Smith CR, La Rocca N, Lopez S: A multicenter randomized, double-blind, placebo-controlled trial of influenza immunization in multiple sclerosis. Neurology 1997;48:312–314.
  42. Moriabadi NF, Niewiesk S, Kruse N, Jung S, Weissbrich B, ter Meulen V, Toyka KV, Rieckmann P: Influenza vaccination in MS. Absence of T-cell response against white matter proteins. Neurology 2001;56:938–943.
  43. Confravreux C, Suissa S, Saddier P, Bourdès V, Vukusic S: Vaccinations and the risk of relapse in multiple sclerosis. N Engl J Med 2001;344:319–326.
  44. Fredrikson S, Cheng Q, Jiang GX, Wasserman D: Elevated suicide risk among patients with multiple sclerosis in Sweden. Neuroepidemiology 2003;22:146–152.
  45. Comstock GW, Markush RE: Further comments on problems in death certification. Am J Epidemiol 1986;124:180–181.
  46. Israel RA, Rosenberg HM, Curtin LR: Analytical potential for multiple cause-of-death data. Am J Epidemiol 1986;124:161–179.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50