Geographical distribution of multiple sclerosis mortality in Spain

Mortality from multiple sclerosis in Spain has been analyzed for the period 1969-1979. In this period 1841 deaths from MS as primary cause were registered. The death rate decreased markedly during the first years, but was steady between 1975 and 1979 with 0.35 deaths per 100,000 population. This value places Spain within the low-medium risk zone of MS. The geographical distribution by provinces shows a slight northern predominance, with the highest rates in the northwestern area.     

Geographic distribution of dementia mortality: elevated mortality rates for black and white americans by place of birth

We hypothesized that patterns of elevated stroke mortality among those born in the United States Stroke Belt (SB) states also prevailed for mortality related to all-cause dementia or Alzheimer Disease. Cause-specific mortality (contributing cause of death, including underlying cause cases) rates in 2000 for United States-born African Americans and whites aged 65 to 89 years were calculated by linking national mortality records with population data based on race, sex, age, and birth state or state of residence in 2000. Birth in a SB state (NC, SC, GA, TN, AR, MS, or AL) was cross-classified against SB residence at the 2000 Census. Compared with those who were not born in the SB, odds of all-cause dementia mortality were significantly elevated by 29% for African Americans and 19% for whites born in the SB. These patterns prevailed among individuals who no longer lived in the SB at death. Patterns were similar for Alzheimer Disease-related mortality. Some non-SB states were also associated with significant elevations in dementia-related mortality. Dementia mortality rates follow geographic patterns similar to stroke mortality, with elevated rates among those born in the SB. This suggests important roles for geographically patterned childhood exposures in establishing cognitive reserve.     

Mortality rates from multiple sclerosis: geographical and temporal variations revisited.

A review of the United Kingdom (UK) multiple sclerosis (MS) literature suggests that over the last three decades prevalence and estimated incidence rates have increased, while mortality rates have been declining. UK mortality data over a 30 year period have been studied to examine temporal and geographical variations, to estimate changes in survival, and to examine the relationship between mortality and morbidity trends. The study has shown an overall decline in mortality throughout the UK of approximately 25% over the 30 year period ending in 1983, and a reduction in the mortality differential between Scotland, and England and Wales, but no positive correlation has been found between mortality and morbidity. The overall decline in death rate in females was 23% and in males 30% over the 30 years of the survey. The total number of deaths declined by 39% between the five year periods 1954-58 and 1979-83 in Scotland compared with a 10% decline for England and Wales. Estimated median age of death increased from 52 to 59 years and the improvement in survival over the period of study was similar for both countries and is unlikely to have contributed to the reduction in mortality differential. Within England and Wales regional mortality rates did not show a clear north-south gradient. The decline in the mortality differential between Scotland and England (if not artefactual) may provide an important aetiological clue in the search for the cause of multiple sclerosis, and the rate of decline suggests an environmental rather than a genetic aetiology.     

Trends in mortality from suicide, 1965-99

OBJECTIVE: To analyse trends in mortality from suicide over the period 1965-99. METHOD: Data were derived from the WHO database, including data for 47 countries. RESULTS: In the European Union (EU), all age suicide mortality peaked at 16.1/100,000 in men in 1980-84, and declined thereafter to 14.4/100,000 in 1995-98. In females, the fall was 29% to reach 4.6/100,000. A similar pattern of trends was observed in several eastern European countries. In contrast, mortality from suicide rose substantially in the Russian Federation, from 37.7/100,000 in males in 1985-89 to 58.3/100,000 in 1995-98 (+55%), and to 9.5/100,000 (+12%) in females. In the USA and most other American countries providing data, no consistent pattern was evident for males, but falls were observed in females. Steady declines were registered for Japan, starting from the highest suicide rates worldwide in the late 1950s. Suicide rates were upwards in Ireland, Italy, Spain, the UK, Cuba, Australia and New Zealand. Substantial rises were observed in a few countries (Ireland, Cuba, Mexico, Australia and New Zealand) for young males. CONCLUSION: In spite of mixed trends, suicide remains a significant public health problem worldwide.     

Epidemiology of multiple sclerosis in Western Poland – a comparison between prevalence rates in 1965 and 1981

An epidemiological survey of multiple sclerosis was carried out in the western part of Poland. The estimated prevalence rate on December 31, 1981 was compared with that established on the same territory on January 1, 1965. The disease was less frequent in 1981. The prevalence rate for definite cases was only 42.87 versus 51.19. A marked increase of population in the younger age groups (those under 20) during the last decade may account for the observed differences in the prevalence rate. In the town of Gniezno, a new MS cluster with a prevalence rate of 118.10 per 100,000 population was discovered.     

Anorexia nervosa mortality in Northeast Scotland, 1965-1999

OBJECTIVE: Most previous studies of mortality in anorexia nervosa patients have shown an increased risk of premature death but have been limited by methodological constraints. This study aimed to overcome some of these constraints by having a large original sample size, diagnosis confirmed by case note review, a long duration of follow-up, and a clear base population. METHOD: The authors identified 524 anorexia nervosa cases seen in specialist services in Northeast Scotland; anorexia nervosa diagnosis was confirmed by scrutinizing case notes. Those who had died were identified from the National Health Service register or register of deaths. The death rates and causes of death were analyzed. RESULTS: Twenty-three patients died, giving a crude death rate of 4.4% and a standardized mortality rate of 3.3 (95% CI=2.2-4.9). In only one-third of the cases was anorexia nervosa on the death certificate, but an eating disorder or other psychiatric pathology probably contributed to several of the other deaths. Older age at the time the patient was seen at the specialist service was the only identifiable risk factor in the group of patients who died. The median length of time between diagnosis and death was 11 years. CONCLUSIONS: Anorexia nervosa is associated with increased risk of premature death. It is possible that death rates could be reduced by early diagnosis and by long-term specialist care.     

World-wide trends in multiple sclerosis mortality

Mortality attributed to multiple sclerosis (MS) was analyzed for 35 countries around the world using World Health Organization reports from 1965 to 1984. Trends were plotted for the United States and Canada, for various regions of Europe, Israel, South America, Asia, Australia and some Pacific countries. In general, MS mortality has declined steadily in North America and most of western Europe as well as in countries with a western culture but has remained stable or increased in eastern and northern Europe. Although several Mediterranean countries reported a recent increased frequency of MS, it was not (yet?) evident in mortality data. Intensive prospective surveillance of MS frequency trends in selected regions of the world will determine the validity of the trends based on mortality.     

Geographic distribution of deaths due to Parkinson's disease in Canada: 1979-1986

Mortality figures for Parkinson's disease in Canada from 1979 to 1986 were examined by province and by sex. As seen in other studies, Parkinson's disease showed a statistically significantly higher prevalence in males than in females (p less than 0.01). An uneven distribution across provinces was found when mortality rates were compared by males and when males and females were grouped together. Females did not show a significant variation across provinces. Five provinces showed a higher incidence of Parkinson's disease among males than in females (p less than 0.05), whereas the other provinces showed no difference. British Columbia and Manitoba showed the highest rates for males as well as the highest rates when males and females were grouped together. The uneven geographic distribution of Parkinson's disease offers support for the possible involvement of environmental factors in the etiology of some forms of idiopathic Parkinson's disease. Suggestions for further research are outlined.     

Epidemiology of multiple sclerosis in London and Middlesex County, Ontario, Canada

A case-controlled epidemiologic study of multiple sclerosis (MS) was carried out in London, Ontario, and its surrounding Middlesex County for the period 1974-1983. The prevalence rates for clinically definite/probable MS on January 1, 1984 were 94/100,000 for the city and 91/100,000 for the county. The estimated annual incidence rate for the decade 1974-83 was 3.4/100,000. The female-to-male sex ratio was 2.5:1. A familial history of MS was recorded in 14.4% of close relatives and a total of 17% when distant relatives are included. The MS group is predominantly of British (70%) and European (23%) origin. The urban-rural residence pattern analysis indicates no significant regional influence on the risk of developing MS.     

Prevalence of multiple sclerosis in Barrhead County, Alberta, Canada.

A prevalence study of multiple sclerosis (MS) was carried out in the town of Barrhead and surrounding county of Barrhead, in Alberta, Canada. The prevalence rate for clinically probable/definite multiple sclerosis on January 1, 1990 was 196/100,000. The average annual incidence rates for patients living in the area at onset were 1.31/100,000 for 1950-59, 4.97/100,000 for 1960-69, 3.77/100,000 for 1970-79, and 4.22/100,000 for 1980-89. Fifty percent of the patients were relapsing-remitting. Sixty percent were still walking without assistance. The female-to-male ratio was 1:1. Mean current age, age at onset and duration of illness were 49, 27 and 22 years respectively. The majority of patients (40%) experienced multiple symptom onset. Fifty percent were of single ethnic origin (either British or German); the rest were predominantly North European combinations. Forty percent of patients reported another MS relative. MS had affected the work status of 60% of the patients, 15% of whom were confined to an extended care centre.     

Regional variation of multiple sclerosis prevalence in Canada

OBJECTIVE: To describe the regional distribution of multiple sclerosis (MS) prevalence in Canada, controlling for age and sex. METHODS: This study used data from the Canadian Community Health Survey, a large general health survey (n = 131,535) conducted in 2000/2001. Subjects aged 18 and over were included in the current analysis (n = 116,109). The presence of MS was determined by self-report. Prevalence was computed in five regions (Atlantic, Quebec, Ontario, Prairies and British Columbia). Logistic regression was used to compare regions and examine for confounding/interaction by age and sex. RESULTS: The overall Canadian MS prevalence was 240 per 100000 (95%CI: 210 280). Prevalence ranged from 180 (95%CI: 90-260) in Quebec to 350 (95%CI: 230-470) in Atlantic Canada. Logistic regression revealed no statistical difference between the odds of MS in Quebec, Ontario and British Columbia adjusted for age and sex. The adjusted odds of MS in the Prairies and Atlantic regions were significantly higher than in the other regions combined, with odds ratios of 1.7 (95%CI: 1.1-2.4, P <0.01) and 1.6 (95%CI: 1.1-2.4, P <0.05) respectively. Sensitivity analysis demonstrated similar prevalence in the nonaboriginal/nonimmigrant group (n = 96219). CONCLUSION: Results suggest that Canadian MS prevalence differs by region. If validated, these regional differences may facilitate investigation of environmental influences.     

Canadian trends in mortality from mental disorders, 1965-1983

This report describes trends in the death rate for all mental disorders, presenile and senile dementia, and alcoholic psychoses and alcohol abuse/dependence in Canada for the period 1965-1983. It is demonstrated that overall there has been an increase in the death rate for each of these causes of mortality, both for males and females, and that in the case of presenile and senile dementia the increase has been particularly rapid. The older age groups appear to be contributing most to the observed changes. Conjectures are made as to the underlying reasons for the observed trends.     

Regional and temporal variation in the incidence of multiple sclerosis in Finland 1979-1993

Previous surveys in Finland from the 1960s have documented an uneven geographic distribution of multiple sclerosis (MS). In the present study, the incidence of MS was studied during 1979-1993 in the western Vaasa and Sein?joki regions and in southern Uusimaa. The overall difference between the western and southern regions persisted; 8.7 per 100,000 in the western, and 5.1 per 100,000 in the southern region. The incidence of 11.6 per 100,000 in Sein?joki was more than twofold greater than the 5.2 per 100,000 incidence found in neighboring Vaasa. An increasing incidence trend was observed for men in Sein?joki, and a decrease for both sexes in Vaasa, while in Uusimaa the incidence remained stable for both sexes. The different incidence trends could not be readily explained by differences in case ascertainment but suggest the effect of environmental factors that have modulated the incidence of MS during the 15-year study period.     

Disability and mortality in multiple sclerosis in Western Norway

Introduction – Continued studies of frequency trends in carefully selected sites around the world can provide clues to the cause of multiple sclerosis (MS). Material and methods – Based on information from three different, semi-independant sources of information, we have examined the temporal trends in the average annual age-adjusted rates of disability pension incidence, mortality, and incidence of MS from 1966 to 1991 in More and Romsdal County, Norway. Results – The average annual age-adjusted disability pension incidence rates (1966–68 = 3.62/100,000; 1990–91 = 7.33/100,000), the mortality rates (1966–68=0.91/100,000; 1990–91 = 1.88/100,000), and the incidence rates (1966–68 = 4.22/100,000; 1990–91 = 5.02/100,000) all showed a statistically significant increase. The difference in the development of MS-specific disability pension prevalence rates in the county compared to the nation is notable. Conclusions – We consider that the increase in disability pension incidence, mortality, and incidence of MS is of biological significance. Thus three different sources of information corroborate corresponding trends indicating that better case ascertainment and improved diagnostic facilities only partially can explain the reported MS increase in western Norway.