While there are many new treatments emerging that can stem progression of multiple sclerosis (MS), there is no cure. Disability typically increases over time, affecting ambulation and quality of life. MS patients have a shorter life expectancy (approximately 10 years shorter than the general population). However, most MS patients die of complications from MS rather from the disease process itself. This is a call to action for patients that it is not enough to take medications to stem the disease. Your future health depends on focusing on more than just your MS as some of the factors that reduce your lifespan can be prevented.
The most common causes of death in MS patients:
- Your heart and vessels: Diseases of the blood vessels in your heart, brain and other areas of the body can lead to stroke, heart attacks and blood clots to your lungs (pulmonary embolism).
The main mechanisms responsible for greater vascular risk in MS patients identified so far include so far are the cardiovascular autonomous nervous system dysfunction, physical inactivity due to disability, oxidative stress and endothelial dysfunction and the presence of cardiovascular risk factors in MS (inflammation status, smoking, arterial hypertension, diabetes mellitus, high cholesterol and triglycerides, obesity, psychosocial stress and an increased tendency to have blood clots (procoagulant status). The autonomic system is composed of the sympathetic and parasympathetic nerves and is affected in MS from lesions in regions of the central nervous system that controls it. Sympathetic dysfunction correlates with the clinical activity of MS and parasympathetic dysfunction correlates with the progression of disability in patients with MS. Oxidative stress result from an imbalance between oxidants and antioxidants which leads to molecular damage. This damage occurs in the endothelial cells which line bloods vessels and the heart.
- Cancer: People with MS may not necessarily have a higher risk of dying from cancer than the general population but some studies have shown a slightly higher risk of developing certain cancers, such as bladder, prostate and breast cancer. The increased incidence may actually be due to increased MRI screening in MS patients.
The suppression of the immune system to control MS may lower the body’s defenses against developing cancer (the immune system seeks out and destroys cancer cells it detects).
- Respiratory illness: MS patients are more likely to die from chronic respiratory disease than the general population. Respiratory dysfunction can arise from infection, from MS-related weakness of the muscles involved in breathing, and from MS damage to parts of the brain that control breathing.
- Infection: Respiratory infections are responsible for approximately 13 percent of deaths in the general population as compared to approximately 23 percent of deaths in the MS population.
Urinary tract infections are more common in the MS population because of the use of catheters, urinary retention (MS-related inability to empty the bladder). Pressure ulcers of the skins from not getting out of bed can be troublesome infections for MS patients.
The use of MS drugs that suppress the immune system make such infections more serious and deadly.
How you can protect yourself:
- Regular visits with your primary care doctor for all your non-MS health related needs, such as controlling chronic conditions like diabetes, high blood pressure and high cholesterol levels.
- Quit smoking
- Get more exercise
- If you have breathing problems, perform exercise that strengthens the chest muscles which are responsible for breathing.
- Contact your clinician at the first signs of infection.
Most importantly, remember that having MS is not a death sentence. You can take control of many aspects of your health to live a long and meaningful life. While the average MS patient has a shortened lifespan, that does not mean you will. BeCare MS can help you to track your disability and neurologic health so that you can work with your clinician to get the best MS care appropriate for you.