The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
Incidence of MS has increased markedly over six decades in Denmark particularly with late onset and in women
Abstract
Objective To describe the pattern of development of incidence of multiple sclerosis (MS) over 60 years in Denmark with age-period-cohort analyses and seasonality of birth. Methods Data on virtually all patients with onset of MS have since 1950 been prospectively recorded and kept in the Danish Multiple Sclerosis Registry with multiple sources of notification. Annualized incidence rates per 100,000 were directly standardized to the European Standard Population. Results We have registered 19,536 cases with clinical onset of confirmed MS in Denmark from 1950 to 2009. From the 1950-1959 to the 2000-2009 onset period, incidence more than doubled in women, with an increase from 5.91 (95% confidence interval [CI]: 5.60-6.24) to 12.33 (95% CI: 11.91-12.75) per 100,000 per year compared with a modest 24% increase in men from 4.52 (95% CI: 4.24-4.81) to 6.08 (95% CI: 5.79-6.38). With age at onset of 50 years and older, incidence increased with a factor 4.30 in women and 2.72 in men. The female/male sex ratio increased over time and with year of birth. Age-period-cohort analysis revealed a significant birth cohort effect in addition to the age and period effect. We found no statistically significant seasonality of births. Conclusion The incidence of MS has doubled in women, most pronounced with late onset, and has only modestly increased in men. Lifestyle changes in the female population that could include fewer childbirths, increased occurrence of obesity, and increased cigarette consu…
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“An analysis of data from the Danish Multiple Sclerosis Registry showed that incidence in women doubled between 1950 and 2009, whereas increases among men have been more modest.31”
From Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 (2019) · cites this paper as [31]
In the citing paper
“Environmental changes that might be contributing to the rapid change in incidence among women include the rise in obesity, increased cigarette smoking, and changes in the frequency of breastfeeding infants.31, 33”
From Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 (2019) · cites this paper as [31]
Citations
Cites
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The Danish Civil Registration System
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Temporal trends in the incidence of multiple sclerosis
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Wallin, M. T., Culpepper, W. J., Nichols, E., Bhutta, Z. A., Gebrehiwot, T. T., Hay, S. I., Khalil, I. A., Krohn, K. J., Liang, X., Naghavi, M., et al. (2019) · The Lancet Neurology · doi:10.1016/s1474-4422(18)30443-5 · Cited by 1,134
Epidemiology and treatment of multiple sclerosis in elderly populations
Vaughn, C. B., Jakimovski, D., Kavak, K. S., Ramanathan, M. K., Benedict, R. H. B., Zivadinov, R., & Weinstock‐Guttman, B. (2019) · Nature Reviews Neurology · doi:10.1038/s41582-019-0183-3 · Cited by 320
Epstein–Barr virus as a leading cause of multiple sclerosis: mechanisms and implications
Bjornevik, K., Münz, C., Cohen, J. I., & Ascherio, A. (2023) · Nature Reviews Neurology · doi:10.1038/s41582-023-00775-5 · Cited by 246
Uncovering sex differences of rodent microglia
Han, J., Fan, Y., Zhou, K., Blomgren, K., & Harris, R. A. (2021) · Journal of Neuroinflammation · doi:10.1186/s12974-021-02124-z · Cited by 224
Apparent changes in the epidemiology and severity of multiple sclerosis
Koch‐Henriksen, N., & Magyari, M. (2021) · Nature Reviews Neurology · doi:10.1038/s41582-021-00556-y · Cited by 230
Self-citation
Metadata
- Authors
- Koch-Henriksen, N., Thygesen, L. C., Stenager, E., Laursen, B., & Magyari, M.
- Affiliations
- From the Clinical Institute (N.K.-H.), Department of Clinical Epidemiology, University of Aarhus; Danish Multiple Sclerosis Registry (N.K.-H., E.S., M.M.) and Department of Neurology (M.M.), Rigshospitalet, University of Copenhagen; National Institute of Public Health (L.C.T., B.L.), University of Southern Denmark in Copenhagen; Institute of Regional Health Research (E.S.), University of Southern Denmark, Odense.
- University of Copenhagen (DK)
- Venue
- Neurology
- Published
- 2018-05-29
- Volume
- 90
- Issue
- 22
- Pages
- e1954-e1963
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2799594477
- Cited by
- 188
- References
- 45
- Citations by year
- 2026: 17 · 2025: 25 · 2024: 23 · 2023: 25 · 2022: 27 · 2021: 19 · 2020: 21 · 2019: 25 · 2018: 6
- FWCI
- 13.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Keywords
- multiple sclerosis, incidence trends, sex differences, late-onset multiple sclerosis, birth cohort effects, birth seasonality, age-period-cohort analysis, lifestyle factors, Denmark
- MeSH terms
- Adult, Denmark, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Prospective Studies, Registries, Sex Factors, Incidence, Age of Onset, Young Adult
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