A Incidence per 10 5 patient years in women and men all age groups. Mortality rates fell in the GPRD population over the study period. In the 70—year age group, for example, they fell from 5. Among other age groups, the proportional decline was similar. The mortality rate among patients with MS was more than twice that of other patients in all age groups and in both sexes, but also declined at a similar proportional rate.
Life expectancy rose from We applied the age-specific mortality ratios for people with and without MS observed in the present study to estimate changes in life expectancies in people with MS over the same decade. They increased from Incidence and prevalence of multiple sclerosis in women and men by age General Practice Research Database — A Incidence per 10 5 patient years.
B Prevalence per 10 5 patients. The highest prevalence and incidence rates were observed in Scotland. Among the other 12 regions of the UK, latitude accounted for HES identified an additional prevalent cases and incident cases in men and prevalent cases and incident cases in women. Age-specific correction factors were estimated. We also estimated the numbers of incident and prevalent cases of MS in the four countries which comprise the UK table 5.
The overall prevalence of MS increased by approximately 2. We observed a decline in the rate at which new cases of MS were diagnosed, and the rising prevalence rate can likely be accounted for by trends in mortality rates. There was a consistent downward trend in overall incidence of MS in the whole study population over the year study period, and the rate of decline did not differ between men and women or with age.
It is possible that this is due to new diagnostic techniques which reduced the risk of false positive diagnoses over the study period. We were not able to analyse the effects of prior pregnancy on the age of onset of MS in women in this study, although it has previously been reported that pregnancy reduces the risk of onset of MS. We found the highest incidence and prevalence rates among the 13 regions of the UK in Scotland, but no trend with latitude among the other 12 regions.
This suggests that the difference between Scotland and other regions of the UK is probably not the result of a consistent trend with latitude, but may involve factors not associated with latitude.
A major strength of this study is that it covers a representative sample of GPs spread geographically throughout the UK, and a patient population with age and sex distributions similar to those of the general UK population.
The study population of some 4 million patients provides greater statistical precision than earlier regional surveys. Our analyses depend upon the accuracy of diagnosis and recording of MS by GPs: The prevalence rates we found are slightly higher than the rates reported by Thomas et al in , also using the GPRD: Alonso and colleagues reported incidence rates of 7. An overall incidence rate of MS of 3. The downward trend in incidence that we found is in contrast to studies in Denmark, where the female incidence of MS has almost doubled since the s while male incidence has remained constant.
Moreover, separate surveys carried out and analysed at different times may be subject to methodological differences. It is not clear why our study has detected a decreasing incidence while others have suggested increasing incidence. Changes in awareness of MS and the challenges of diagnosing MS may account for changes incidence over time.
However, we could identify no specific reason why the methodology or data source we used should have had an impact on our finding of decreasing incidence of MS over the period of the study. In the current study, the mean female-to-male ratio for MS was 2. For example, a recent analysis of trends in the sex ratio in MS for individuals born between and found a marked increase in Northern Europe not including the UK from 2. This may be partly accounted for by changing health-related behaviours of men in recent years, perhaps having more contact with medical services than was the case historically.
We are not able to identify any particular reason why the study methodology or data source could have confounded our findings regarding sex-ratio. A recent study using HES data for the period — showed regional variations in hospital admission rates for MS in England. Early studies on MS suggested a trend with latitude with increasing prevalence in more temperate climates in Northern and Southern hemispheres.
Regional variation in MS epidemiology may be due to genetic or environmental factors and interactions between them. This is supported by studies on the effect of month of birth on subsequent risk of MS in Northern and Southern hemispheres.
Further studies are needed to investigate the causative factors of MS, particularly the role of Vitamin D, genetic susceptibility factors and infective agents. This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades. It shows that more than people in the UK were newly diagnosed with MS in and that patients with MS are living longer, leading to a rising population living with the disease.
This has important implications for resource provision in the UK. All authors were involved in drafting and reviewing the manuscript. Statistical analysis was carried out by SVM. The guarantor for the study is ISM. This grant supported study meetings but MSNTC had no input into the design of the study, collection, analysis or interpretation of the data or in the decision to submit the paper for publication.
All authors have completed the Unified Competing Interests form at http: The other authors have no non-financial interests that may be relevant to the submitted work. Provenance and peer review: Not commissioned; externally peer reviewed. National Center for Biotechnology Information , U. Journal of Neurology, Neurosurgery, and Psychiatry.
J Neurol Neurosurg Psychiatry. Published online Sep Received Mar 22; Accepted Aug For permission to use where not already granted under a licence please go to http: This article has been cited by other articles in PMC. Abstract Objectives To estimate the incidence and prevalence of multiple sclerosis MS by age and describe secular trends and geographic variations within the UK over the year period between and and hence to provide updated information on the impact of MS throughout the UK.
Design A descriptive study. Background Individuals with multiple sclerosis MS can experience high levels of disability and impaired quality of life for prolonged periods.
Hypothesis This was a descriptive study. Study population The study population included all patients with acceptable data who contributed follow-up time to the database after Statistical analysis The analysis plan is shown in figure 1. Open in a separate window. Mortality rates were analysed using logistic regression models. Office for National Statistics We applied these adjusted age-specific and gender-specific incidence and prevalence rates to population statistics obtained from the Office for National Statistics ONS for the UK population to estimate the absolute numbers of new and prevalent cases of MS in the UK population in Secular trends The prevalence of MS increased by about 2.
Strengths and weaknesses of the study A major strength of this study is that it covers a representative sample of GPs spread geographically throughout the UK, and a patient population with age and sex distributions similar to those of the general UK population. Relation to other studies The prevalence rates we found are slightly higher than the rates reported by Thomas et al in , also using the GPRD: Conclusions This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades.
Supplementary Material Web figures: Click here to view. Multiple sclerosis in the UK Service use, costs, quality of life and disability. Adjustment to multiple sclerosis in individual or group delivery format. Participants completed mood and quality of life assessments at baseline and at four-month follow-up. Measures of feasibility included: Participants were screened for inclusion using the General Health Questionnaire and Hospital Anxiety and Depression Scale, and were randomly allocated to receive either individual or group intervention, with the same content.
Twenty-one participants were recruited mean age There were no statistically significant differences between the groups on the outcome measures of mood and quality of life. The intervention could be provided on an individual basis and the trial design was feasible.
There were lower attendance rates at group sessions compared to individual sessions. Social identity in people with multiple sclerosis: A meta-synthesis of qualitative research.
Purpose-Many aspects of the self are lost as a consequence of having multiple sclerosis MS. The Social Identity Model of Identity Change argues that previously established identities form a basis of continued social support, by providing grounding and connectedness to others to facilitate the establishment of new identities.
Family support is a salient factor in adjustment to MS and may enable the establishment of new identities. The purpose of this paper is to investigate identity reconstruction following a diagnosis of MS. Characteristics influencing therapy switch behavior after suboptimal response to first-line treatment in patients with multiple sclerosis.
Factors driving disease-modifying therapy DMT switch behavior are not well understood. The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal response to DMT.
Of suboptimal responders, Compared with one relapse alone, MRI worsening alone most strongly predicted switch behavior odds ratio 6. Younger patients with disease activity, especially MRI changes, are more likely to have their therapy switched sooner than patients who are older at the time of MS diagnosis and DMT initiation.
Fingolimod Therapy in Early Multiple Sclerosis: To investigate the efficacy of fingolimod at the approved 0. The reproductive effects of beta interferon therapy in pregnancy: To determine whether interferon therapy during human pregnancy increases reproductive risks in women. This longitudinal, controlled cohort study consisted of three groups of women: Subjects were selected from women contacting the Motherisk Program regarding maternal beta interferon exposure, mostly for multiple sclerosis during pregnancy, from to After delivery all of the women were re-contacted for a follow-up interview regarding maternal health, pregnancy outcome, and neonatal health.
Women exposed to beta interferon had a higher rate of miscarriages and stillbirths Beta interferon therapy in the first trimester of pregnancy appears to be associated with an increased risk for fetal loss and low birth weight. To assess the impact of fingolimod FTY therapy on magnetic resonance imaging measures of inflammatory activity and tissue damage in patients participating in a 2-year, placebo-controlled, phase 3 study.
Patients with active relapsing-remitting multiple sclerosis were randomized to receive fingolimod, 0. Standardized magnetic resonance imaging scans were obtained at months 0, 6, 12, and 24 and centrally evaluated for number and volume of T1 gadolinium-enhancing, T2 hyperintense, and T1 hypointense lesions and for percentage of brain volume change.
Findings were compared across subgroups by treatment and baseline characteristics. Worldwide, multicenter clinical trial. We measured the effect of therapy on acute inflammatory activity, burden of disease, and irreversible loss of brain volume. Changes in T2 hyperintense and T1 hypointense lesion volume also significantly favored fingolimod P. These results, coupled with the significant reductions in relapse rates and disability progression reported previously, support the positive impact on long-term disease evolution.
The neural cell adhesion molecule NCAM present in the cerebrospinal fluid of multiple sclerosis patients is unsialylated. The neural cell adhesion molecule NCAM is a glycoprotein localised in the plasma membrane of neural and glial cells, which plays a role in myelination and remyelination.
It increases in the cerebrospinal fluid CSF of acute multiple It increases in the cerebrospinal fluid CSF of acute multiple sclerosis MS patients treated with corticosteroids who are improving after an attack, but it has not been shown if it appears in its sialylated PSA or unsialylated form. A candidate marker of remyelination. Multiple Sclerosis MS is an autoimmune neurodegenerative disease that affects several people especially in North America and Canada.
In , 33 individuals over , were affected from MS; the estimated increase for 5 years of In , 33 individuals over , were affected from MS; the estimated increase for 5 years of observation ranged from an average of 4. Association of regional gray matter volume loss and progression of white matter lesions in multiple sclerosis — A longitudinal voxel-based morphometry study.
Previous studies have established regional gray matter GM volume loss in multiple sclerosis MS but the relationship between development of white matter WM lesions and changes of regional GM volumes is unclear. The present study addresses this issue by means of voxel-based morphometry VBM.
The present study suggests that the progression of regional GM volume reductions is associated with WM lesion progression and occurs predominantly in fronto-temporal cortical areas. Brain atrophy has been identified as an important contributing factor to the development of disability in multiple sclerosis MS. In this respect, more and more interest is focussing on the role of deep grey matter DGM areas. However, in clinical trials, often no such high-resolution data are acquired and hence no conclusions regarding the impact of new treatments on DGM atrophy were possible so far.
The thalamus, putamen, pallidum, nucleus accumbens, and caudate nucleus were bilaterally segmented using FIRST. Volumes were calculated for each structure and for the sum of basal ganglia BG Effect of immunomodulatory medication on regional gray matter loss in relapsing—remitting multiple sclerosis—A longitudinal MRI study.
Spatiotemporal relations between longitudinal gray matter and white matter lesion changes in multiple sclerosis — A combined parametric and non-parametric voxel-based morphometry study. Ads help cover our server costs. Remember me on this computer. Enter the email address you signed up with and we'll email you a reset link. Click here to sign up.
Multiple Sclerosis Research Papers delve into a sample of a paper ordered for an analysis of the degenerative disorder.
Introduction Multiple Sclerosis is a demyelization disorder of the central nervous system and the spinal cord; which leads to patches of plaques in the regions.
- This research paper, will discuss the pathophysiological, psychosocial, economic and cognitive effects which Multiple Sclerosis (MS) has on the affected individual, family and society. It will make mention of how a professional nurse would support the individual, the family/carer. View Multiple sclerosis Research Papers on hesmatcchfet.cf for free.
Health term papers (paper ) on Multiple Sclerosis A+ Research Paper : Introduction Multiple Sclerosis Stephanie **** Multiple Sclerosis (MS) is a chronic, often disabling disease that randomly attacks the ce. Term paper Incidence and prevalence of multiple sclerosis in the UK – a descriptive study in the General Practice Research Database I S Mackenzie, 1 S V Morant, 1 G A Bloomfield, .