Given the high risk for stroke in this MS population and the observed complexity among the coincident common risk factors for circulatory diseases, the high risk for type 1 diabetes and common infections raise a need to recognize patients at risk with these conditions and with the other known risk factors such as metabolic syndrome and smoking. The survival disadvantage related to circulatory diseases observed in general population is true also in MS and should be recognized to reduce the burden of disease and premature mortality in MS.
Background. MS incidence has increased among females, suggesting the presence of environmental effect.
Object. Regional differences and temporal changes in gender-specific MS incidence were studied in Finland.
Methods. Cases from Jan 1, 1981 to Dec 31, 2010 in Pirkanmaa, Seinäjoki and Vaasa districts were included. The standardized incidence rates (SIR),
incidences per 105 person years with 95% confidence intervals (CI), and female-to-male ratios (F/M) were determined by district.
Results. 1617 cases were included. Compared to Pirkanmaa, the MS risk was 1.9-fold (95% CI: 1.7–2.0) greater in
Seinäjoki and 1.2-fold (95% CI: 1.1–1.4) in Vaasa, and the risk was high for both genders.
The incidence trend stabilized in Seinäjoki and Vaasa, accompanied by an increase in the F/M ratio.
A steady increase in Pirkanmaa was accompanied by a high F/M ratio.
Conclusion. A high female preponderance accompanied a general increase
in incidence since the 1990s, suggesting the influence of environmental factors. In high-risk districts,
increased MS risk prevailed in both genders. High risk reflects both genetic and environmental effects.
These effects may be shared with autoimmune diseases such as type 1 diabetes mellitus;
the incidence of which follows MS in Finland. Population-based case-control studies are needed to identify these factor effects.
Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89%) RRMS and 198 (11%) PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M) from 4,2/105 (F/M 1.9) to 9,7 (2.3), while that of PPMS decreased from 1,2 (1.6) to 0,7 (1.2). The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.
Objective
To study ten‐year change in MS prevalence in the Province of Western Finland in Tampere University Hospital District located in 62.7°N, 23.7°E.
Methods
Age‐standardized prevalence/105 by using direct standardization in European Standard Population (ESP2013) and crude prevalence/105 with 95% confidence interval (95% CI) were assessed among resident MS cases fulfilling Poser criteria by sex and disease course in 31.12.2000 and 31.12.2010. MS‐related disability and disease‐modifying treatment (DMT) use were estimated in 31.12.2010.
Results
Crude prevalence increased 49% from 129/105 (95% CI 121‐137) in 2000 (N 1080) to 196/105 (187‐203) in 2010 (N 1666). Age‐standardized prevalence increased 45% from 133/105 (127‐140) to 192/105 (184‐200) and peaked in 40‐ to 49‐year age‐group. Age‐standardized prevalence increased 58% among women from 176/105 (171‐176) to 277/105 (270‐284) and 31% among men from 91/105 (87‐95) to 119/105 (115‐124). Increase in RRMS was 61% from 111/105 (105‐117) to 179/105 (171‐186), and decrease in PPMS was 14% from 21/105 (19‐24) to 18/105 (15‐21).
In 2010 among the 52% RRMS cases on DMT, MS‐related disability was mild in 50%. In total, cohort disability was mild in 46%, moderate to severe in 47%, and information was not available in 14%.
Conclusion
A significant increase in prevalence was observed in Western Finland. Increase was higher among women and in relapsing‐remitting onset MS. Disability showed age‐ and disease course‐specific variation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.