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Although treatment options for multiple sclerosis (MS) have improved, there’s still no cure for MS. People living with MS have an average life expectancy that’s around seven years shorter than the general population’s. This is especially true for those who have MS with comorbidities (other health conditions). Today, the underlying cause of death in people with MS is more likely to be complications of the disease than MS itself.
If you’re living with MS or caring for a loved one with the condition, it’s normal to wonder how the disease affects life expectancy. Studies analyzing the death certificates of people with MS in Canada and the U.S. have shed light on the most common causes of death.
Vascular disease is one of the most commonly reported causes of death in people with MS. Vascular disease is a broad category of conditions that involve the blood vessels (arteries and veins). Vascular diseases may be genetic, caused by lifestyle choices related to smoking and diet, or both. Vascular disease can become deadly if blood clots cause strokes, heart attacks, or pulmonary embolisms (when a clot travels to the lungs).
Vascular diseases, including cardiovascular disease (heart disease), are also the leading cause of death in the general population. However, studies show that people with MS have higher relative mortality (death rates) from cardiovascular diseases than the general population.
Controlling conditions like diabetes, hypertension (high blood pressure), and high cholesterol levels can help prevent vascular diseases. If you have a vascular disease, you may be able to treat it with medication, surgery, or lifestyle changes like getting more exercise or quitting smoking.
Cancer is another leading cause of death for all people. People with MS don’t necessarily have an increased risk of cancer death compared to the general population, and it remains unclear if there is any connection between MS and cancer-related deaths.
Studies suggest lung cancer is one of the most frequently reported causes of death in people with MS. Breast and colorectal cancer are also high on the list. In addition, some people with MS may have a slightly higher risk of certain cancers, such as bladder, brain, and cervical cancer. However, other factors may have influenced this association, like the more frequent brain MRIs in people with MS, which may allow for increased recognition of brain cancers. Some studies even suggest that MS may have a potential protective effect against cancer, though more research is needed.
The relationship between MS and cancer is complicated. MS is often treated with medications that suppress the immune system to protect the nervous system. Although these treatments are critical for slowing the disease course of MS, they can also come with side effects. For example, they may lower defenses against other threats, such as cancer.
Additionally, some of the disease-modifying therapies (DMTs) for MS have been used to treat cancer. Researchers still aren’t quite sure how all of these different factors may play into the development of cancer in people with MS.
Fortunately, you and your neurology team have a lot of different DMTs to choose from to treat your MS. Your healthcare provider will look at your specific situation, including your cancer risk, when selecting your treatment.
A chronic respiratory disease is any type of ongoing breathing or lung problem. Some studies suggest that people with MS are most likely to die from respiratory failure. However, statistics may vary depending on how the study was designed and where and when it was performed.
Respiratory disease is also a common cause of death for people without MS, but it’s lower on the list among the general population. According to a study published in the journal Neurology, chronic respiratory disease in MS is associated with a higher mortality risk in men than in women, but the evidence is mixed.
MS-related breathing problems are common. Sometimes, they happen early in the disease or are caused by an infection. Other times, they’re the result of severe disability from MS that has progressed to more advanced stages. In more advanced MS, the muscles needed for breathing can become weak. As a result, breathing becomes more tiring and difficult. MS can also impact parts of the brain that control breathing, but this is rare.
People with MS are more likely to get certain types of chronic respiratory diseases than others. For example, chronic obstructive pulmonary disease (COPD) is more common in MS. But people with MS may have a similar or higher risk of asthma than people without MS, depending on the study.
It’s crucial to get breathing problems diagnosed and treated as soon as they start. Targeted exercises can strengthen your chest muscles to help prevent weakness that makes breathing harder. In addition, learning strategies to prevent chest infections (such as avoiding talking while eating) can also help.
People with MS have a higher mortality risk from infections compared to those without the disease. As noted above, respiratory infections are a serious concern.
One study found that, in the general population, respiratory infections are responsible for 12.7 percent of deaths. However, in MS populations, this number goes up to 22.5 percent. This data was based on adult deaths reported in British Columbia, Canada, from 1986 to 2013. It’s possible that the number of deaths would be different in a different place or time, especially given the worldwide impact of the COVID-19 pandemic.
Respiratory infections can happen if you swallow food the wrong way, if you accidentally inhale a tiny amount of food, or if you’re exposed to a virus or bacteria that makes you sick.
Urinary tract infections (UTIs) also pose a significant risk. People with MS tend to get UTIs more often due to the use of catheters and urinary retention (the inability to fully empty the bladder).
According to the journal Neurology, in the general population, women are more likely to get UTIs. Among people with MS, the association with death and UTIs was actually stronger in men than in women.
If a person with MS becomes immobile, they can develop pressure ulcers. These sores can quickly grow into widespread infections that enter the bloodstream and put life at risk. That said, infections are treatable, especially if you catch them early.
Signs of an infection differ depending on the type. In general, they can include:
If you have a wound and notice that it’s not healing well, don’t wait to get medical treatment. People with MS must be vigilant about treating infections, especially if they are on therapies that suppress the immune system. Open communication with your healthcare team is essential for keeping you safe.
Learning about different causes of death can be difficult. But remember, everyone’s situation is unique. You can lower your risk of certain chronic diseases by making good lifestyle choices. Above all, staying in touch with your healthcare team (including your neurologist) can help you get treatment before small issues become life-threatening.
Maintaining a healthy diet and active lifestyle are good ways to avoid preventable death for everyone. For those with MS, choosing nutritious snacks and avoiding inflammatory foods may be especially helpful.
Managing MS may be your main health focus, but it’s not the only thing that deserves your attention. A diagnosis of MS isn’t a death sentence. The best way to care for your or your loved one’s health is with regular and preventive medical care. Scheduling recommended screenings (like blood work and colonoscopies) and attending follow-ups may impact mortality rate and help extend the lifespan of people with MS.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
How has MS affected your views on life and death? Let others know in the comments below.
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In other words, MS is just like everyone else. We die from the same things as our friends.
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