Demographic Characteristics of Multiple Sclerosis in South East Wales

Swingler, Robert; Compston, D. A. S.

doi:10.1159/000110753

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…a north‐to‐south gradient (north‐east mainland and the Scottish off‐shore islands versus southern England and Wales), a marked increase of prevalence with repeated assessments over time especially in southern regions and the subsequent tendency for the latitudinal gradient to level off [23]. A prevalence rate of 187 per 100 000 was reported for the year 1995 in south‐east Scotland [24], which is at least twofold that for England and Wales [25–29]. Even higher rates of nearly 200 cases per 100 000 were found for Scotland offshore islands (Shetlands and Orkneys), but they were based on the small populations and older diagnostic criteria [30,31].…”

Section: Resultsmentioning

confidence: 99%

“…The most recently reported prevalence estimate of MS for northern Ireland was 168 per 100 000, indicating a risk similar to that in Scotland, probably because of the close genetic composition and ethnicity between the Scottish and the northern Irish population [35]. In England and Wales, the prevalence reported from different areas over the last two decades has varied from 84 to 112 MS cases per 100 000 [25–29,36–38]. No latitudinal gradient between northern and southern England was disclosed by Ford et al [38] by means of a prevalence study conducted in the Leeds Health Authority in northern England for the year 1996 and showing a total crude prevalence rate of 97 per 100 000.…”

Section: Resultsmentioning

confidence: 99%

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The epidemiology of multiple sclerosis in Europe

Pugliatti

Rosati

Carton

et al. 2006

Euro J of Neurology

543

352

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Multiple sclerosis (MS) is a chronic and potentially highly disabling disorder with considerable social impact and economic consequences. It is the major cause of nontraumatic disability in young adults. The social costs associated with MS are high because of its long duration, the early loss of productivity, the need for assistance in activities of daily living and the use of immunomodulatory treatments and multidisciplinary health care. Available MS epidemiological estimates are aimed at providing a measure of the disease burden in Europe. The total estimated prevalence rate of MS for the past three decades is 83 per 100 000 with higher rates in northern countries and a female:male ratio around 2.0. Prevalence rates are higher for women for all countries considered. The highest prevalence rates have been estimated for the age group 35-64 years for both sexes and for all countries. The estimated European mean annual MS incidence rate is 4.3 cases per 100 000. The mean distribution by disease course and by disability is also reported. Despite the wealth of epidemiological data on MS, comparing epidemiological indices among European countries is a hard task and often leads only to approximate estimates. This represents a major methodological concern when evaluating the MS burden in Europe and when implementing specific cost-ofillness studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The epidemiology of multiple sclerosis in Europe

Pugliatti

Rosati

Carton

et al. 2006

Euro J of Neurology

543

352

View full text Add to dashboard Cite

show abstract

“…A cross-sectional epidemiological study of MS in Cardiff and Vale University Health Board was established in 1985,24 with data updated periodically between 1985 and 1999 25 26. Since 1999 prospectively acquired longitudinal clinical data has been collected on all people with MS on an annual basis where possible.…”

Section: Methodsmentioning

confidence: 99%

Contemporary study of multiple sclerosis disability in South East Wales

Harding

Ingram

Tallantyre

et al. 2022

J Neurol Neurosurg Psychiatry

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BackgroundA contemporary understanding of disability evolution in multiple sclerosis (MS) is an essential tool for individual disease management and planning of interventional studies. We have used prospectively collected longitudinal data to analyse disability progression and variation in a British MS cohort.MethodsCox proportional hazards regression was used to estimate hazard of Expanded Disability Status Scale (EDSS) 4.0 and 6.0. A continuous Markov model was used to estimate transitional probabilities for individual EDSS scores. Models were adjusted for age at MS onset, sex and disease-modifying treatments (DMTs) exposure.Results2135 patients were included (1487 (70%) female, 1922 (89%) relapsing onset). 865 (41%) had used DMTs. Median time to EDSS 4.0 and 6.0 was 18.2 years (95% CI 16.3 to 20.2) and 22.1 years (95% CI 20.5 to 24.5). In the Markov model, the median time spent at EDSS scores of <6 (0.40–0.98 year) was shorter than the time spent at EDSS scores of ≥6 (0.87–4.11 year). Hazard of change in EDSS was greatest at EDSS scores <6 (HR for increasing EDSS: 1.02–1.33; decreasing EDSS: 0.34–1.27) compared with EDSS scores ≥6 (HR for increasing EDSS: 0.08–0.61; decreasing EDSS: 0.18–0.54).ConclusionsThese data provide a detailed contemporary model of disability outcomes in a representative population-based MS cohort. They support a trend of increasing time to disability milestones compared with historical reference populations, and document disability variation with the use of transitional matrices. In addition, they provide essential information for patient counselling, clinical trial design, service planning and offer a comparative baseline for assessment of therapeutic interventions.

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The prevalence of multiple sclerosis in the world: an update

Rosati

2001

Neurological Sciences

570

405

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The systematic study of multiple sclerosis (MS) in populations, started in 1929 by Sydney Allison, now consists of over 400 publications dealing with the prevalence of MS throughout the world. However, any attempt to redefine the pattern of geographical differences in MS frequency remains as difficult as ever. The comparison of prevalence studies carried out in different areas and times is made difficult by the variability in surveyed population sizes, age structures, ethnic origins and composition, and the difficult quantification of numerators, especially regarding the recognition of benign and very early cases. Additionally, complete case ascertainment depends on access to medical care, local medical expertise, number of neurologists, accessibility and availability of new diagnostic procedures, the degree of public awareness about MS, and the investigators' zeal and resources. Critical examination of the more recent data on MS prevalence leads to some revisions of previously held concepts, the most interesting of which is the appreciation of the greater influence of genetic factors on disease acquisition. The rarity of MS among Samis, Turkmen, Uzbeks, Kazakhs, Kyrgyzis, native Siberians, North and South Amerindians, Chinese, Japanese, African blacks and New Zealand Maoris, as well as the high risk among Sardinians, Parsis and Palestinians, clearly indicate that the different susceptibilities of distinct racial and ethnic groups are an important determinant of the uneven geographic distribution of the disease. The updated distribution of MS in Europe, showing many exceptions to the previously described north-south gradient, requires more explanation than simply a prevalence-latitude relationship. Prevalence data imply that racial and ethnic differences are important in influencing the worldwide distribution of MS and that its geography must be interpreted in terms of the probable discontinuous distribution of genetic susceptibility alleles, which can however be modified by environment. Because the environmental and genetic determinants of geographic gradients are by no means mutually exclusive, the race versus place controversy is, to some extent, a useless and sterile debate.

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Demographic Characteristics of Multiple Sclerosis in South East Wales

Cited by 6 publications

References 17 publications

The epidemiology of multiple sclerosis in Europe

The epidemiology of multiple sclerosis in Europe

Contemporary study of multiple sclerosis disability in South East Wales

The prevalence of multiple sclerosis in the world: an update

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