Other illnesses and life expectancy
AAN 2015 – Part 1
American Academy of Neurology 67th annual meeting
Washington, DC, April 18-25, 2015
Life expectancy is somewhat shorter for people with multiple sclerosis compared to the non-MS population, often because of problems associated with impaired mobility (Scalfari and colleagues. Neurology 2013;81:184-192). However, MS can overshadow other important health concerns, such as heart disease, diabetes and cancer. Several presentations at the American Academy of Neurology annual meeting addressed different aspects of this issue.
An analysis of people in Manitoba, Canada, found that average life expectancy was 76 years among people with MS compared to 83 years in the general population (Marrie and colleagues. AAN 2015; abstract P1.115). However, the most common causes of death were not directly related to MS. Also important were diabetes, heart disease, mental health issues (depression, anxiety, bipolar disorder) and chronic lung disease. Curiously enough, migraine and thyroid disease were associated with improved survival.
A number of studies have found that people with MS have a lower risk of most cancers, although the reasons for this are not well understood (Handel and colleagues. J Neurol Neurosurg Psychiatry 2010;81:1413-1414). But an important question to examine is whether MS therapies change the cancer risk. The New York State MS Consortium database was analysed to compare people with MS with and without cancer (Gaindh and colleagues. AAN 2015; abstract P1.119). The study found that the overall rate of cancer was low: 1.4% (compared to 3.2% in the general population). There was no difference in the use of MS medications for those with or without cancer, suggesting that treatments do not have an impact on cancer risk.
A U.S. study looked at the illnesses that have the greatest impact on MS severity (Xia and colleagues. AAN 2015; abstract P1.118). The most disabling conditions were bladder problems, muscle spasms, osteoporosis, skin ulcers, depression and fatigue. Heart conditions and diabetes were also important. A separate study in Canada reported that most people with MS have more than one medical condition, including about 40% who suffer from chronic pain (Fiest and colleagues. AAN 2015; abstract P1.114). The pain conditions that have the greatest impact on a person’s quality of life are irritable bowel syndrome, rheumatoid arthritis and fibromyalgia. People with anxiety and depression suffered more from MS fatigue.
These findings emphasize the interactions of MS and other medical conditions and demonstrate the need to treat the whole person. The results also underscore the importance of regular check-ups by a family doctor to maintain overall good health.
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