In multiple sclerosis (MS), the immune system attacks and destroys the fatty myelin coating that surrounds and insulates nerve cells in a process known as demyelination. MS is a lifelong condition, and common symptoms include fatigue, muscle spasms, walking difficulties, or numbness and tingling of the face, body, arms, and legs. These symptoms can worsen over time, affecting daily activities and reducing a person’s quality of life.
The disease is highly variable, and some people are affected more than others upon and after diagnosis. Treatments are available to help manage a number of symptoms.
Life expectancy for people with MS has increased considerably in the last 20 to 25 years. On average, however, a person with MS can expect to live seven fewer years than someone without this disease.
According to the National MS Society, on average, an MS patient lives about seven fewer years than someone in the general public, largely because of disease complications or other medical conditions, like cardiovascular disease. Only rarely does the disease progress so quickly that it is deadly.
Due to advances in treatments, care, and lifestyle adjustments, MS often progresses slowly. Many studies show that, nowadays, about two-thirds of all patients retain a fair degree of mobility — the ability to walk, although likely with an assisted device — some 20 years after being diagnosed. Assisted devices can range from supports to aid in walking, to scooters used on occasion to save energy and avoid fatigue.
The course of the disease depends on each patient’s risk factors, like having a family member with MS, cigarette smoking, and vitamin D sunlight exposure. And, among African-Americans, the disease tends to be a more progressive form and progression can be quicker.
MS prognosis is thought to be better for people with relapsing-remitting MS than for those with progressive forms of MS, likely because of a better response to disease-modifying therapies.
Studies on life expectancy in MS
A 2013 review study published in the Neurology journal, citing data “from numerous large cohort registries”— “Mortality in patients with multiple sclerosis” — estimated that people with MS live on average 7–14 fewer years others. It, however, also considers MS and survival a “poorly described aspect of the disease.” The study found many factors that affect life expectancy in these patients, including the age at MS onset, the level of severity, the rate of disease progression, and types of treatment available. Long-term disability is not necessarily a cause of death for MS patients.
Another study, from 2014, compared the lifespan of more than 30,400 people with MS to 89,800 people without MS using a U.S. commercial health insurance database. Although with some limitations (the study did not consider type or severity of MS, or information on other medical conditions), the study found that the average life expectancy of MS patients in the U.S. is shortened by six years compared to those without MS.
Another study, co-funded by the MS Society of Canada, and titled “Effect of comorbidity on mortality in multiple sclerosis,” also looked at this issue in 2015, comparing an MS population (almost 6,000 people) with a non-MS group matched by age and gender (almost 89,000). Researchers here evaluated the impact of other medical conditions (comorbidities) like diabetes, heart or lung diseases, or depression on life expectancy in both groups. They also concluded that life expectancy with MS is reduced by seven years, although has increased over the past 25 years. Study results, importantly, highlight the importance of treating comorbidities in MS patients, and of adopting a healthier lifestyle as ways of improving life expectancy.
Factors that affect life expectancy
As mentioned, life expectancy in MS is getting better, for reasons that range better treatments, to improved healthcare and lifestyle adaptations.
- Better treatments. Because of “disease-modifying” therapies, people with relapsing forms of MS are living longer than those not on these treatments, provided they stay on a therapy. The National MS Society refers to these therapies as the “best strategy currently available” to slow the disease’s natural progression.
- Improved healthcare and lifestyle changes. Paying attention to factors that affect the quality of life and adopting a healthier lifestyle can help to reduce the risk of other conditions, such as cardiovascular diseases. Recommended lifestyle changes include quitting smoking, getting regular physical exercise and drinking less alcohol. A healthy diet can help to better manage some symptoms, such as fatigue, and bladder and bowel problems.
Beginning treatment as early as possible in MS is highly recommended for patients, as it might slow the disease’s advance.
Here are some factors that imply a faster MS progression, and disability accumulation, in a person. But it is a prognosis snapshot for today, based on clinical signs and tests results that might aid a longer term estimate of progression. As new therapies are introduced and new insights into MS arise, their relevance can change:
Multiple Sclerosis Prognosis Snapshot
- Being older than age 40 at the onset of symptoms;
- Having more than two attacks in the first two years after onset;
- Having symptoms that affect urinary control, mobility, or mental functioning at disease onset, or having initial symptoms in many different areas of the body;
- Showing a high frequency of relapses, since repeat early relapses can cause the disease to progress quickly;
- Showing a high number of brain or brainstem lesions in an MRI scan at the time of diagnosis, or showing new or gadolinium-enhancing lesions in an MRI, implying active inflammation;
- Scoring more than 1.5 on the Expanded Disability Status Scale (EDSS, a scale that quantifies disability) after a second attack.