Summary: A comprehensive study reveals that the recorded prevalence of multiple sclerosis (MS) in England more than doubled between 2000 and 2020. This 6% annual increase is attributed primarily to earlier, more accurate diagnostic techniques and significantly improved life expectancy for those living with the condition.
While the transition to better disease-modifying therapies has extended lifespans, the study also identified a stark “deprivation gap,” where individuals in lower socioeconomic areas face higher mortality rates and potential barriers to early diagnosis. The findings, estimate that approximately 190,000 people are currently living with MS in England.
Key Facts
- Prevalence Surge: Standardized MS prevalence rose from 107 per 100,000 people in 2000 to 232 per 100,000 in 2020, representing a doubling of recorded cases over two decades.
- Longevity Gains: Patients diagnosed later in the study period showed significantly lower annual mortality rates and a higher likelihood of living to age 80 compared to previous decades.
- The Socioeconomic Paradox: While the highest prevalence was found in the least deprived areas (likely due to better diagnostic access), the highest mortality occurred in the most deprived regions.
- Modifiable Risk Factors: Quitting smoking and maintaining a healthy weight were strongly associated with lower mortality, highlighting lifestyle intervention as a critical tool for reducing avoidable deaths.
Source: UCL
Multiple sclerosis (MS) has more than doubled in recorded prevalence in England from 2000 to 2020, increasing by 6% per year, largely due to improved diagnosis and longer life expectancy, finds a new study by University College London (UCL) and Imperial College London researchers.
The team found that survival of people with MS improved significantly over time thanks to advances in treatments and care, although they also identified inequalities, with higher mortality in deprived areas.
In the study published in JAMA Neurology, the researchers estimate that 190,000 people are living with MS in England today.
Lead author Professor Olga Ciccarelli (NIHR Research Professor of Neurology, UCL Queen Square Institute of Neurology) said: “People with MS are living longer than ever before, thanks to better care, disease-modifying therapies, and earlier diagnosis, but there is still much more to do.
“We found that quitting smoking and maintaining a healthy weight were both associated with lower mortality. Therefore, tackling smoking, obesity, and inequalities in access to diagnostics and care could reduce avoidable deaths and help people with MS stay healthier for longer.”
MS is a neurological condition in which the immune system attacks the central nervous system. Most people are diagnosed between the ages of 20 and 50, but the first signs of MS can start years earlier. Common early signs include tingling, numbness, limb weakness, and problems with vision, but it can take time to reach a definitive diagnosis.
The researchers reviewed over 30 years of public health records, using a very large database of primary (GP) care records in England from 1990 to 2023, some of which were also linked to secondary (hospital) care data. They identified possible MS cases based on multiple sources including diagnostic records and prescription of drugs that are exclusively used to treat MS.
They estimated that standardised prevalence (how common MS is across the population, adjusted for differences in age, sex and region) increased from 107 per 100,000 people in 2000 to 232 per 100,000 in 2020. This corresponded to an estimated 131,000 people living with MS in 2020. In adjusted analyses, prevalence increased by 6% per year. Extrapolating that trend forward, the researchers project that approximately 190,000 people are likely living with MS in England today.
The researchers also found that survival improved through the study period, as people are living longer with MS after diagnosis; those diagnosed later in the study period were more likely to live to 80 years old and had lower annual mortality rates.
Mortality was found to be highest in deprived areas, while prevalence was highest in the least deprived areas. The researchers say this suggests that people in deprived areas are more likely to be living with undiagnosed MS, while evidence also suggests they have lower access to care, may be accessing treatments later on in the disease course, and are more likely to be living with other health conditions.
The researchers highlight that smoking and obesity both contribute to poor outcomes for MS, and as smoking and obesity rates are higher in deprived areas, this may be contributing to inequalities in MS outcomes.
First author Professor Raffaele Palladino (Imperial College London and University of Naples Federico II) said: “While much progress has been made in improving MS diagnosis and access to treatments that extend lifespans and improve quality of life, there is still more work to be done. Efforts to improve earlier diagnosis should be particularly focused on reaching socioeconomically disadvantaged groups who might face greater barriers to diagnosis and care.”
Dr Catherine Godbold, Senior Research Communications Manager at the MS Society, commented: “Exploring the role of deprivation in MS outcomes is important research. It’s encouraging to see evidence showing improvements in life expectancy for people with MS. But we need to see more consistent access to diagnosis, treatment, and support for people to manage their symptoms so that everyone with MS, whatever their circumstances or where they live, can live well.
“We know smoking and obesity can worsen MS, and this study suggests targeted support around stopping smoking and maintaining a healthy weight could also be crucial in reducing inequalities in MS outcomes.”
Funding: The study was supported by the National Institute for Health and Care Research (NIHR), the MS Society, and the NIHR UCLH Biomedical Research Centre.
Key Questions Answered:
A: It’s more of a “diagnostic success.” The doubling of cases isn’t necessarily due to more people getting the disease, but rather doctors getting better at catching it early and patients living much longer thanks to modern treatments.
A: It’s a combination of access and lifestyle. People in deprived areas often face barriers to early diagnosis and specialized drugs, while also dealing with higher rates of smoking and obesity, which significantly worsen MS outcomes.
A: Yes. The study confirms that staying at a healthy weight and quitting smoking are directly linked to lower mortality. These factors are just as important as medical treatments for long-term health.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this neurology and aging research news
Author: Chris Lane
Source: UCL
Contact: Chris Lane – UCL
Image: The image is credited to Neuroscience News
Original Research: Closed access.
“Thirty-Year Trends in Multiple Sclerosis Prevalence, Lifestyle Factors, and Mortality in England” by Raffaele Palladino, Alan Thompson, and Olga Ciccarelli. JAMA Neurology
DOI:10.1001/jamaneurol.2026.0352
Abstract
Thirty-Year Trends in Multiple Sclerosis Prevalence, Lifestyle Factors, and Mortality in England
Multiple sclerosis (MS) prevalence is increasing,1 driven by improved diagnosis, expanded access to specialist care and disease-modifying therapies, and population aging. How tobacco use, obesity, and socioeconomic deprivation are associated with survival remains unclear. Using national primary care data in England, we examined 30-year trends in MS prevalence, smoking, and body mass index (BMI) and assessed associations with all-cause mortality.
