We aimed to compare survival in the multiple sclerosis (MS) population with a matched cohort from the general population, and to evaluate the association of comorbidity with survival in both populations.
Using population-based administrative data, we identified 5,797 persons with MS and 28,807 controls matched on sex, year of birth, and region. We estimated annual mortality rates. Using Cox proportional hazards regression, we evaluated the association between comorbidity status and mortality, stratifying by birth cohort, and adjusting for sex, socioeconomic status, and region. We compared causes of death between populations.
Median survival from birth in the MS population was 75.9 years vs 83.4 years in the matched population. MS was associated with a 2-fold increased risk of death (adjusted hazard ratio 2.40; 95% confidence interval: 2.24–2.58). Several comorbidities were associated with increased hazard of death in both populations, including diabetes, ischemic heart disease, depression, anxiety, and chronic lung disease. The magnitude of the associations of mortality with chronic lung disease, diabetes, hypertension, and ischemic heart disease was lower in the MS population than the matched population. The most common causes of death in the MS population were diseases of the nervous system and diseases of the circulatory system. Mortality rates due to infectious diseases and diseases of the respiratory system were higher in the MS population.
Received support as site Principal Investigator for clinical trials from Sanofi-Aventis (2007-2014)
Received support as principal investigator from the Canadian Institutes of Health Research (2010-2019), the Public Health Agency of Canada (2010-2013), and Research Manitoba (2014-2019).
Received support as principal investigator from Multiple Sclerosis Society of Canada (2009-2016) and the National Multiple Sclerosis Society (2013-2014), and as co-principal investigator from Multiple Sclerosis Scientific Foundation (2009-2015). Received support from Consortium of Multiple Sclerosis Centers (2004-2009, 2011-2014).
(1) Canadian Institutes for Health Research, “Reducing inequities in access to and use of prenatal care in the Winnipeg Health Region through health system improvement”, Co-Investigator, (M. Heaman PI), 2012-2015 (2) Canadian Institutes for Health Research, “Developing a diabetes prevention intervention: Identifying and targeting contextually-relevant stressors”, Co- Investigator, (S. Bruce PI), 2012-2015
(1) Multiple Sclerosis Society of Canada, The Impact of Comorbidity and Secular Time on Hospitalizations and Mortality in MS, Co-Investigator (RA Marrie PI), 2012-2014
EMD Serono Canada: travel and honorarium for participation as faculty for a neurology resident review course for the Royal College of Physicians and Surgeons of Canada Specialty Examination
Diagnostic Services Manitoba, Primary Investigator, 2010- 2012
University Research Grants Program (University of Manitoba), Primary Investigator, 2010-2011
CIHR ($2,498,495, 2013/4 - 2018/3), Advancing primary healthcare for persons living with HIV in Canada, co- investigator, PI Dr. Clare Liddy. Multiple Sclerosis Society of Canada ($155,599, 2012/7 - 2015/6), The impact of comorbidity and secular time on hospitalizations and mortality in MS, co-investigator, PI Dr. Ruth Ann Marrie. National Multiple Sclerosis Society ($317,843, 2012/7- 2015/6), Adherence to immunomodulators in Multiple Sclerosis: prevalence and clinical impact (the AIMS Study), collaborator, PI Dr. Helen Tremlett. CIHR Emerging Team Grant ($1,500,000, 2010/4 - 2015/3), Team in the epidemiology & impact of comorbidity on MS (ECoMS), co-investigator, PI Dr. Ruth Ann Marie. Gilead Sciences ($96,000, 2013/4 - 2014/3). Missed opportunities for diagnosis for HIV epidemiological study (MODES Manitoba), co-investigator, PI Dr. Marissa Becker. CIDA(International development grant, $20,000), Building capacity to respond to HIV/AIDS in China: Extending the impact. Co-investigator, PI Dr. James Blanchard. CIHR Emerging Team: HIV/AIDS vaccine discovery and social research ($750,000), Team in the socio-cultural aspects of implementing HIV vaccine programs among MSM and FSWs in Asia and Africa. co-investigator, PI Dr. Robert Lorway. CIDA (International development grant, $990,000), Capacity building to respond to HIV/AIDS in China. Co- investigator, PI Dr. James Blanchard.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by an operating grant from the MS Society of Canada.
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