Chapter 10 - Prognosis

Summary

LIFE EXPECTANCY

In the older literature on MS, disease duration from diagnosis to death is regularly reported as between 13 and 20 years (for overview, see Matthews 1991). The life expectancy of MS patients used to be considered to be reduced by 14 to 18 years compared to that of the average population. According to more recent studies (Confavreux et al. 1980; Phadke 1987), an average disease duration of at least 25 to 39 years may be expected; in a third of cases it is longer than 30 years. At the turn of the century, only 10 of 200 MS patients lived longer than 20 years, and only 2 of those longer than 30 years (Bramwell 1917). Nowadays, the average probable lifespan of MS patients 10 years after onset of the disease may be reduced by approximately 10 years in comparison to the normal population. Only in patients with disease onset after the 50th year of life is mean life expectancy 10 years after disease onset reduced, by 44% for men, and by 22% for women compared to members of the average population (Phadke 1987).

A good indicator of survival time after disease onset is the length of the interval between the first and the next relapse: of patients dying within 10 years after disease onset, all had had their second relapse within 2 years after disease onset, whereas in almost half of the patients alive 40 years after disease onset, the interval between the first and second relapse was more than 10 years (Phadke 1987).