Mortality Trends of Multiple Sclerosis in Spain, 1951–1997: An Age-Period-Cohort Analysis

Abstract

Trends of multiple sclerosis mortality in Spain from 1951 to 1997 are examined. Age-adjusted mortality strongly decreased from 3.08 per 100,000 women in 1951–1967 to 0.59 in 1968–1980 (similar figures were obtained for men). This decrease seems to be due to an artifact produced by changes in codification of causes of death. An age-period-cohort analysis, limited to the period 1968–1997, showed that the mortality trend in Spain cannot be fully explained by year of death (period effect), but that a cohort (year of birth) effect is also necessary. An increase in mortality related with the cohort of birth was detected: people born after 1953 had double the risk of those born between 1938 and 1947, and four times the risk of those born between 1923 and 1932. Regarding the period effect, there is a decrease in mortality, probably due to improvements in life expectancy of multiple sclerosis patients.

Birth Cohort Effects in Neurological Diseases: Amyotrophic Lateral Sclerosis, Parkinson’s Disease and Multiple Sclerosis

“…Preliminary APC analyses [12] , and analyses using a similar APC approach, which have been carried out with Swedish data [9] , and also with Spanish data [10] , have yielded similar results. Analyses using a descriptive approach [8] or regional data [11] have been less conclusive.…”

“…We appreciated the comparative approach and took the opportunity to shed light on these three neurological diseases with a contemporary statistical analysis. In MS, the APC approach has been applied to Swedish data [9] , Spanish data [10] , regional Norwegian data [11] , and a preliminary Swiss study [12] , mostly providing evidence for birth cohort effects. To the best of our knowledge, no APC studies have been published with regard to ALS and to PD.…”

“…However, if for some reason the change did not take place for all age groups in parallel [10] , new age profiles might have emerged which mimic birth cohort effects. Accordingly, we implemented a nested approach in APC analysis to account for changing age profiles over the 20th century.…”

Multiple Sclerosis Mortality by Race/Ethnicity, Age, Sex, and Time Period in the United States, 1999–2015

“…Multiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system that disproportionately affects whites and is associated with high morbidity and early mortality [1-5]. Other racial/ethnic minorities, including blacks, Hispanics and Asians, are also at risk of developing MS, although reported to have lower incidence rates in the United States [6, 7].…”

Survival and cause of death in multiple sclerosis: a prospective population-based study

“…Nationally and regionally acquired mortality statistics collected through the use of death certificates are the most widely available source of data and are commonly used to study temporal patterns of disease,4 – 8 document common causes of terminal comorbidity and to estimate prevalence data for allocation of healthcare resources 9. However, patients with MS may die either from the direct effect of the disease, or unrelated causes; the majority of studies reporting approximately 60–70% of deaths being attributable to the disease itself or its complications 10 – 17.…”