ORIGINAL RESEARCH article
Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1685316
Global, regional, and national trends and burden of multiple sclerosis in adolescents and young adults: A data analysis from 1990 to 2021 and projections to 2040
Provisionally accepted
Peixi Zhao1
Chang Guan1Baitong Wang2
Ying Zhang2
Tianying Chang2
Lin Huang3
Ding Ye3Hongmei Nan2
Jian Wang2
Peng Xu2*- 1Changchun University of Chinese Medicine, Changchun, China
- 2Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
- 3Zhejiang Chinese Medical University, Hangzhou, China
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Background and Objectives: Multiple sclerosis (MS) significantly impacts adolescents and young adults (aged 15 - 39 years), causing substantial neurological disability. Despite therapeutic advances, the global burden persists due to disparities in healthcare access and lifestyle factors. This study analyzes global, regional, and national trends and burdens of MS using Global Burden of Disease (GBD) 2021 data, emphasizing the influence of the Socio-demographic Index (SDI). Methods: Using data from the GBD 2021 data, we conducted a secondary analysis. We assessed the prevalence, mortality, and disability-adjusted life years (DALYs) of MS across 204 countries/territories from 1990 to 2021, calculating age-standardized rates. Results: In 2021, global MS prevalence was 489,310 cases, associated with 1,424 deaths and 215,869 disability-adjusted life years (DALYs). The global age-standardized rates per 100,000 were: prevalence 22.2 (19.8 - 24.8), deaths 0.2 (0.2 - 0.2), and DALYs 11.4 (9.8 - 13.2). Compared to 1990, these rates decreased by 0.4%, 12.8%, and 11.0% respectively, while the number of prevalent cases increased by 52.4%. Sweden (161.6), Canada (134.2), and Norway (131.5) had the highest age-standardized prevalence. The UK (71.3) had the highest and Nauru (0.4) the lowest age-standardized DALY rate. Female MS death rates exceeded those of males across all ages, peaking at 20 - 24 years. Regionally, age-standardized DALY rates showed an inverse V-shaped relationship with the SDI. Discussion: Although the global MS burden among adolescents and young adults (AYAs) decreased, the substantial and rising prevalence demands attention. The burden from premature mortality and stark geographic variations in prevalence and DALYs indicate inadequate disease management, underscoring the need for enhanced awareness and effective interventions. Urgent, targeted healthcare policies are required to address geographical inequities, sex-specific pathophysiology, and modifiable risk factors such as smoking.
Keywords: Multiple Sclerosis, Epidemiology, Global burden of disease, Adolescents and young adults, disease projections
Received: 13 Aug 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Zhao, Guan, Wang, Zhang, Chang, Huang, Ye, Nan, Wang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Peng Xu, xupeng@ccucm.edu.cn
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