Summary: A major new analysis shows that recorded prevalence of multiple sclerosis (MS) in England more than doubled between 2000 and 2020. The study attributes a roughly 6% annual increase in recorded cases mainly to earlier and more accurate diagnosis and to substantial improvements in life expectancy for people living with MS.
Researchers also uncovered persistent inequalities: although recorded prevalence was highest in the least deprived areas—likely reflecting better diagnostic access—mortality was highest in the most deprived communities. The authors estimate that about 190,000 people are currently living with MS in England.
Key Facts
- Prevalence Growth: Standardised MS prevalence rose from 107 per 100,000 in 2000 to 232 per 100,000 in 2020, effectively doubling recorded cases over two decades.
- Improved Survival: People diagnosed later in the study period experienced lower annual mortality rates and were more likely to reach age 80 than those diagnosed in earlier decades.
- Socioeconomic Disparities: Higher recorded prevalence occurred in less deprived areas, while higher mortality was concentrated in more deprived areas—suggesting unequal access to early diagnosis, specialist care, and treatments.
- Actionable Risk Factors: Quitting smoking and maintaining a healthy weight were both linked to lower mortality, indicating that lifestyle changes can complement medical treatment to improve outcomes.
Source: UCL and Imperial College London
Overview
A collaborative study by University College London (UCL) and Imperial College London analysed primary care records across England to assess 30-year trends in MS prevalence, lifestyle factors, and mortality. The researchers used a large national primary care database covering 1990–2023, with some records linked to hospital data, and identified MS cases through diagnostic codes and prescriptions for medicines used exclusively to treat MS.
Published in JAMA Neurology, the analysis estimated standardised prevalence—the measure adjusted for age, sex and region—at 107 per 100,000 people in 2000 and 232 per 100,000 in 2020. That 2020 prevalence corresponds to about 131,000 people living with MS at that time; extending observed trends forward, the team projects approximately 190,000 people with MS in England today.
Lead author Professor Olga Ciccarelli, NIHR Research Professor of Neurology at the UCL Queen Square Institute of Neurology, highlighted how better care and disease-modifying therapies have extended lifespans and improved outcomes. She noted that earlier diagnosis and improved treatments are central to the rise in recorded prevalence because more people are surviving longer after diagnosis.
Professor Raffaele Palladino of Imperial College London and the University of Naples Federico II, first author on the paper, emphasised that while diagnostic and treatment advances have helped many people live longer and better, targeted efforts are still needed. “Improving earlier diagnosis and ensuring equitable access to specialist services should focus on socioeconomically disadvantaged groups who may face greater barriers,” he said.
The analysis also linked lifestyle factors to survival. Both quitting smoking and maintaining a healthy body weight were associated with lower mortality among people with MS. Because smoking prevalence and obesity rates are generally higher in deprived communities, these lifestyle differences likely contribute to the observed disparities in outcomes.
MS is an immune-mediated neurological condition that affects the central nervous system. Symptoms commonly begin between ages 20 and 50, though early signs—such as tingling, numbness, limb weakness or visual problems—can appear earlier and contribute to delayed diagnosis in some cases.
The study’s findings carry several implications for clinical practice and public health policy. First, rising recorded prevalence reflects both improved detection and improved survival, reinforcing the need for health services to plan for growing demand for long-term neurological care. Second, the clear socioeconomic gradient in mortality highlights the importance of reducing barriers to diagnosis and specialist treatment in deprived areas. Third, public health measures that reduce smoking and obesity could meaningfully lower avoidable deaths among people with MS.
Key Questions Answered
A: Not necessarily. The apparent surge in cases primarily reflects diagnostic success and improved survival rather than a sudden rise in new-onset disease. Better detection and longer life expectancy explain much of the increase in recorded prevalence.
A: Geographic differences reflect unequal access to timely diagnosis, specialist care and disease-modifying therapies, combined with higher rates of risk factors such as smoking and obesity in deprived areas—all of which worsen outcomes.
A: Yes. The study found that quitting smoking and maintaining a healthy weight are associated with lower all-cause mortality in people with MS, indicating that lifestyle interventions can be a valuable complement to medical treatment.
Editorial Notes
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by the editorial team.
- Additional context was added by staff to clarify implications for health services and public policy.
About this neurology and aging research news
Author: Chris Lane ([email protected])
Source: UCL
Contact: Chris Lane – UCL
Image credit: 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 (summary)
This study examines 30-year trends in MS prevalence, smoking and body mass index (BMI), and associations with all-cause mortality using national primary care data in England. The authors conclude that increasing recorded prevalence is driven by improved diagnosis, expanded specialist care and disease-modifying therapies, and population ageing. The analysis also identifies clear links between socioeconomic deprivation, higher smoking and obesity rates, and worse survival, pointing to targets for public health intervention and service planning.
Funding: The research was supported by the National Institute for Health and Care Research (NIHR), the MS Society, and the NIHR UCLH Biomedical Research Centre.