Advertisement

European Journal of Epidemiology

, Volume 17, Issue 2, pp 105–110 | Cite as

Mortality trend for multiple sclerosis in Italy (1974–1993)

  • T. Tassinari
  • S. Parodi
  • R. Badino
  • M. Vercelli
Article

Abstract

The prevalence of multiple sclerosis (MS) in Italy is one of the highest in Europe, estimated proportions ranging between 32 and 69 cases per 100,000. An update of mortality time trend analyses can help trace a picture of the evolution of the disease and contribute to the interpretation of differences related to latitude and gender. Standardized mortality ratios (SMR) were computed for the 1974–1993 calendar period, using the pooled data set as standard. World population was the standard used to estimate age-adjusted rates for all Italy, while for selected regions the 1991 Italian population was utilized. Time trend analysis was performed using the Poisson regression model and the variation of mortality rates in time was expressed as mean difference per cent per year. Age-adjusted rates per million inhabitants were 4.1 for males and 5.0 for females. Northern Italian regions showed higher MS mortality rates than Central and Southern regions and Sicily, particularly in females; the effect was less evident in Sardinia. Time trend analysis by area showed a mortality decrease in Northern Italy (−1.15%) that reached statistical significance for men. In central regions a slight increase of borderline statistical significance (+1.03%) was observed only in women, while in the South and Sicily a statistically significant increase was seen in both males (+2.14%) and females (+3.09%). The analysis of the time trend for all Italy did not reveal significant variations in male mortality; by contrast, a slight, but statistically significant, increase (+0.88%) was observed in female mortality. Analysis of age-adjusted MS mortality rates in each region suggested the presence of an effect due to latitude. The occurrence of an increasing trend in Southern Italian regions and Sicily deserves further investigation.

Mortality trend Multiple sclerosis Geographic distribution 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Martin CR, Gale CR. The epidemiology of multiple sclerosis. Acta Neurol Scand Suppl 1997; 169: 3–7.Google Scholar
  2. 2.
    Dean G. How many people in the world have multiple sclerosis. Neuroepidemiology 1994; 13: 1–7.Google Scholar
  3. 3.
    Granieri E. Introduction. Neurology 1997; 49(Suppl 2): S2–S3.Google Scholar
  4. 4.
    Lauer K. Editorial. Multiple sclerosis in the old world: The new old map. In: Firnhaber W, Lauer L (eds), Multiple Sclerosis in Europe. An Epidemiological Update. Darmstadt: LTV Press, 1994: 14–27.Google Scholar
  5. 5.
    Rosati G. Epidemiologia della Sclerosi Multipla. In: Rosati G, Granieri E (eds), Manuale di Neuroepidemiologia Clinica. Roma: La Nuova Italia Scientifica, 1990: 142–182.Google Scholar
  6. 6.
    Kurtzke JF, Lux WE Jr. In defence of death data: An example with multiple sclerosis. Neurology 1985; 35: 1787–1790.Google Scholar
  7. 7.
    Meco G, Vanacore N, Bonifati V. The mortality rates for multiple sclerosis in Italy (1969–1987). Neuroepidemiology 1994; 13: 162–174.Google Scholar
  8. 8.
    Sahai H, Khurshid A. Statistics in Epidemiology: Methods, Techniques, and Applications. New York: CRC Press, 1996: 196–200.Google Scholar
  9. 9.
    ISTAT. Popolazione e Abitazioni, 13° Censimento Generale della popolazione e delle abitazioni. Roma: ISTAT, 1995.Google Scholar
  10. 10.
    Kleinbaum DG, Kupper LL, Muller KE. Applied Regression Analysis and Other Multivariable Methods. Boston: PWS-KENT Publishing Company, 1988; 497–512.Google Scholar
  11. 11.
    McCullagh P, Nelder JA. Generalized Linear Models. 2nd edn., London: Chapman & Hall, 1989.Google Scholar
  12. 12.
    SPSS Inc. SPSS Base 7.0 for Windows User's Guide. Chicago: 1996, SPSS Inc.Google Scholar
  13. 13.
    Francis B, Green M, Payne C. GLIM 4.0. The Statistical System for Generalized Linear Interactive Modelling. Oxford: Oxford University Press, 1994.Google Scholar
  14. 14.
    Kurtzke JF, Kurland LT, Goldberg ID, Choi NW. Multiple sclerosis. In: Kurland LT, Kurtzke JF, Goldberg ID (eds), Epidemiology of Neurologic and Sense Organ Disorders. Cambridge, Massachusetts: Harvard University Press, 1973: 64–107.Google Scholar
  15. 15.
    Kurtzke JF, Kurland LT, Goldberg ID. Mortality and migration in multiple sclerosis. Neurology 1971; 21: 1186–1197.Google Scholar
  16. 16.
    Kurtzke JF, Beebe GW, Nagler B, Nefzger MD, Thomas LA, Kurland LT. Studies on the natural history of multiple sclerosis. Arch Neurol 1970; 22: 215–225.Google Scholar
  17. 17.
    Kurland LT, Moriyama IM. Certification of multiple sclerosis as a cause of death. J Am Med Ass 1951; 145: 725–728.Google Scholar
  18. 18.
    Malmgren R, Duddley J, Visscher B. Mortality in persons with multiple sclerosis in the Seattle and Los Angeles areas. J Am Med Ass 1981; 246: 2042–2045.Google Scholar
  19. 19.
    Kurtzke JF. MS epidemiology worldwide. One view of current status. Acta Neurol Scand Suppl 1995; 161: 23–33.Google Scholar
  20. 20.
    Massey EW, Schoenberg BS. International patterns of mortality from multiple sclerosis. Neuroepidelogy 1982; 1: 189–196.Google Scholar
  21. 21.
    Lai SM, Zhang ZX, Alter A, Sobel E. World-wide trends in multiple sclerosis mortality. Neuroepidemiology 1989; 8: 56–67.Google Scholar
  22. 22.
    Dean G, Savettieri G, Giordano D, et al. The prevalence of multiple sclerosis in Sicily II: Agrigento City. J Epidem Comm Health 1981; 35: 118–122.Google Scholar
  23. 23.
    Salemi G, Ragonese P, Scola G, et al. Multiple sclerosis in Sicily: Incidence in Bagheria City, 1985–1994. IXth National Meeting Italian Neuroepidemiology Group [Abstract]. Neuroepidemiology 1998; 17: 36.Google Scholar
  24. 24.
    Savettieri G, Elian M, Giordano D, Grimaldi G, Ventura A, Dean G. A further study on the prevalence of multiple sclerosis in Sicily: Caltanissetta city. Acta Neurol Scand 1986; 73: 71–75.Google Scholar
  25. 25.
    Savettieri G, Salemi G, Ragonese P, et al. Incidence and survival of multiple sclerosis in a Sicilian community. Multiple Sclerosis 1998; 4(4): 390.Google Scholar
  26. 26.
    Savettieri G, Salemi G, Ragonese P, Aridon P, et al. Accuracy of death certificate diagnosis for amyotrophic lateral sclerosis: A comparative analysis in Northern and Southern Italy. Meeting of the World Federation of Neurology [Abstract]. Neuroepidemiology 1997; 16: 12.Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • T. Tassinari
    • 1
  • S. Parodi
    • 2
  • R. Badino
    • 1
  • M. Vercelli
    • 2
    • 3
  1. 1.Azienda Ospedaliera`Ospedale S. Corona'SavonaItaly
  2. 2.Istituto Nazionale Ricerca sul CancroS.A. Registro TumoriGenovaItaly
  3. 3.Dipartimento di Oncologia Biologia GeneticaUniversità di GenovaGenovaItaly

Personalised recommendations