Multiple sclerosis (MS) has more than doubled in recorded prevalence across England over the past two decades, with an estimated 190,000 people now living with the condition. However, this dramatic increase comes with encouraging news: people diagnosed with MS are living significantly longer than they did 20 years ago, thanks to advances in disease-modifying therapies, better care, and earlier detection .

Why Has MS Prevalence Doubled So Dramatically?

The surge in MS cases isn't necessarily because more people are developing the disease. Instead, researchers from UCL and Imperial College London found that the increase from 107 cases per 100,000 people in 2000 to 232 cases per 100,000 in 2020 reflects improved diagnosis and longer survival rates . The prevalence increased by 6% per year throughout the study period, a trend that researchers project will continue, bringing the total to approximately 190,000 people living with MS in England today.

MS is a neurological autoimmune condition in which the immune system attacks the central nervous system, the network of nerves and the brain that controls body functions. Most people receive their diagnosis between ages 20 and 50, though symptoms can begin years earlier. Early warning signs often include tingling, numbness, limb weakness, and vision problems, but reaching a definitive diagnosis can take considerable time .

To identify MS cases, researchers reviewed over 30 years of public health records from 1990 to 2023, using a large database of primary care records from general practitioners in England, some linked to hospital care data. They identified cases through diagnostic records and prescriptions for drugs used exclusively to treat MS .

What's Driving the Improvement in Survival Rates?

The research revealed that survival improved substantially throughout the study period. People diagnosed later in the study were more likely to live to 80 years old and had lower annual mortality rates compared to those diagnosed earlier . This improvement reflects real progress in how MS is managed and treated.

"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," said Professor Olga Ciccarelli, NIHR Research Professor of Neurology at UCL Queen Square Institute of Neurology.

Professor Olga Ciccarelli, NIHR Research Professor of Neurology, UCL Queen Square Institute of Neurology

However, the research also uncovered a troubling pattern: mortality rates were highest in deprived areas, while prevalence was highest in the least deprived areas. This suggests that people in lower-income communities are more likely to be living with undiagnosed MS, have lower access to care, may receive treatments later in their disease course, and are more likely to have other health conditions alongside MS .

How to Improve Outcomes for People With MS

• Quit Smoking: The research found that quitting smoking was associated with lower mortality rates in people with MS, making it one of the most impactful lifestyle changes individuals can make.
• Maintain a Healthy Weight: Maintaining a healthy weight was also linked to lower mortality, suggesting that weight management is an important factor in MS outcomes.
• Improve Access to Early Diagnosis: Efforts to improve earlier diagnosis should be particularly focused on reaching socioeconomically disadvantaged groups who face greater barriers to diagnosis and care.

The connection between lifestyle factors and MS outcomes is particularly important because smoking and obesity rates are higher in deprived areas, which may be contributing to the inequalities in MS outcomes observed in the study .

"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," noted Professor Raffaele Palladino, from Imperial College London and University of Naples Federico II.

Professor Raffaele Palladino, Imperial College London and University of Naples Federico II

The study, published in JAMA Neurology, was supported by the National Institute for Health and Care Research (NIHR), the MS Society, and the NIHR UCLH Biomedical Research Centre . The findings highlight that while medical advances have transformed MS from a condition with poor long-term outcomes into one where people can live well into their 80s, addressing health inequalities remains critical to ensuring all people with MS benefit equally from these improvements.