Multiple sclerosis mortality in New Zealand: a nationwide prospective study

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 94; no. 7; pp. 511 - 517
• Main Authors: Leadbetter, Ruth, MacAskill, Michael, Myall, Daniell J, Taylor, Bruce V, Joshi, Purwa, Mason, Deborah F, Pearson, John F, Clarke, Glynnis, Abernethy, David A, Willoughby, Ernest, Sabel, Clive E
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2023; BMJ Publishing Group LTD
• Subjects: Age; Aged; Cause of Death; Censuses; Child; epidemiology; Humans; Life expectancy; Males; Medical prognosis; Mortality; Multiple sclerosis; Multiple Sclerosis - epidemiology; New Zealand - epidemiology; Prospective Studies; Survival Analysis; New Zealand; epidemiology; multiple sclerosis
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp-2022-330582

BackgroundMortality data from Europe and North America show a shorter life expectancy for people with multiple sclerosis (MS). It is not known if a similar mortality risk exists in the southern hemisphere. We analysed the mortality outcomes of a comprehensive New Zealand (NZ) MS cohort, 15 years postrecruitment.MethodsAll participants of the nationwide 2006 NZ MS prevalence study were included and mortality outcomes were compared with life table data from the NZ population using classic survival analyses, standardised mortality ratios (SMRs) and excess death rates (EDRs).ResultsOf 2909 MS participants, 844 (29%) were deceased at the end of the 15-year study period. Median survival age for the MS cohort was 79.4 years (78.5, 80.3), compared with 86.6 years (85.5, 87.7) for the age-matched and sex-matched NZ population. The overall SMR was 1.9 (1.8, 2.1)). Symptom onset between 21 and 30 years corresponded to an SMR of 2.8 and a median survival age 9.8 years lower than the NZ population. Progressive-onset disease was associated with a survival gap of 9 years compared with 5.7 years for relapsing onset. The EDR for those diagnosed in 1997–2006 was 3.2 (2.6, 3.9) compared with 7.8 (5.8, 10.3) for those diagnosed between 1967 and 1976.ConclusionsNew Zealanders with MS have a median survival age 7.2 years lower than the general population and twice the mortality risk. The survival gap was greater for progressive-onset disease and for those with an early age of onset.