Does Relapsing-Remitting MS Reduce Life Expectancy?

Yes, studies of historical populations show that having multiple sclerosis (MS) can reduce average life expectancy, but being diagnosed with relapsing-remitting multiple sclerosis (RRMS) does not mean you cannot live a long, full life. A major review of historical MS data estimated that the condition is associated with a lifespan reduction of about 7.5 years, with the average life expectancy for someone with MS being around 75.9 years compared to 83.4 years in the general population ^[1].

However, it is vital to understand that this is a historical average for all forms of MS combined, including progressive types and eras before modern medical care. It is not a specific forecast for someone living with RRMS today. Life expectancy for people with MS has been steadily improving over recent decades ^[2]. Long-term survival depends heavily on your specific disease activity, age, overall health, access to care, and the steps you and your medical team take to prevent complications.

Urgent Safety Warning

Seek immediate medical attention if you experience:

• Thoughts of self-harm or suicide: Contact local emergency services, go to the nearest emergency department, or call a crisis line immediately. Do not wait for a routine appointment.
• Severe infection signs: High fever, severe flank pain, confusion, shortness of breath, or repeated choking with meals.
• Serious falls: Any fall resulting in a head injury, severe pain, or inability to move.

The Impact of Modern Treatments

The landscape of MS care has changed dramatically. Disease-modifying therapies (DMTs) are proven to reduce inflammatory disease activity, prevent relapses, and reduce new MRI lesions. While clinical trials for these drugs focus on short-term outcomes, long-term observational research associates consistent DMT use with lower mortality rates ^[3][4].

It is important to note that these are observational associations. Patients who consistently take DMTs might also have better overall access to healthcare or fewer other illnesses, so the medications alone do not guarantee a longer life. The improved survival rates seen in recent decades also reflect earlier diagnoses and better general medical care ^[2]. Never stop or change your DMT without discussing it with your neurologist, as doing so can risk a rebound in MS activity.

Important and Treatable Risk Factors

While population averages cannot predict your individual future, certain complications are associated with a higher mortality risk in MS. Many of these are preventable or manageable.

Infections

In historical data for all MS types, the relative risk of dying from an infection was nearly three times higher than in the general public ^[5]. However, this risk is not uniform; it is highest for those with advanced disability, swallowing problems, or specific medication risks.

• Respiratory infections: Clinically important swallowing difficulties (dysphagia) can cause food or liquid to enter the lungs (aspiration), leading to severe pneumonia ^[6][7]. If you notice coughing or choking with meals, a wet-sounding voice, or unexplained weight loss, ask for a speech-and-swallow evaluation.
• Urinary tract infections (UTIs): Bladder dysfunction is common. However, urgency or incontinence can happen without an infection, and a positive urine test without symptoms often does not require antibiotics. Seek evaluation if you develop new symptoms like fever, flank/back pain, vomiting, or confusion, which can signal a serious systemic infection (an infection that spreads throughout the body) ^[6][8].

Falls and Physical Injuries

Falls are highly prevalent in MS, but the risk depends on your level of disability, fatigue, and vision or gait problems ^[9][10]. Fall risk increases significantly if you take multiple medications, particularly sedatives or muscle relaxants ^[10][11]. Do not taper or stop these medications on your own, as abrupt changes can cause dangerous withdrawal symptoms. Instead, ask your doctor or pharmacist for a medication review. Physical therapy, balance training, and home-safety adjustments can also reduce your risk.

Smoking

Smoking is an important, modifiable risk associated with worse MS and general-health outcomes. In observational studies, current smoking was associated with double the risk of all-cause mortality in people with MS ^[7]. Smoking is also associated with a faster transition from RRMS to secondary progressive MS (SPMS), a phase of steady disability worsening ^[12][13]. Quitting can improve your prognosis, and your doctor can provide practical cessation support, such as counseling or nicotine replacement.

Cardiovascular Disease

People with MS have a higher rate of cardiovascular mortality than the general population ^[5]. In addition to the general health risks, vascular risk factors like high blood pressure, diabetes, and heart disease are associated with greater brain volume loss (atrophy) and higher MS lesion burdens in some studies ^[14]. Managing your blood pressure, cholesterol, and blood sugar is essential for both your heart and your brain.

Depression and Mental Health

Depression is common in MS and is associated with a lower quality of life ^[15]. It is influenced by biology, stress, and sometimes medications. The combination of MS and depression synergistically increases mortality risk ^[16], and historical studies show the relative risk of suicide among people with MS is more than twice that of the general population ^[5]. Depression is a highly treatable condition. Routine screening and prompt individualized care are vital for your long-term well-being.

Medication Complications

While DMTs protect the central nervous system, they can alter the immune system. Risks vary substantially by medication, treatment history, and your baseline immune status. Depending on the drug, risks can include specific viral infections, cardiovascular issues like high blood pressure ^[17], or rare brain infections like progressive multifocal leukoencephalopathy (PML) ^[18]. Your prescribing team will tailor a specific laboratory and infection-monitoring plan to your medication to ensure its benefits continue to outweigh the risks.

Routine Primary and Specialty Care

A long, full life with RRMS requires whole-person care. Build a care team that includes a primary care doctor for routine wellness visits, age-appropriate cancer screenings, blood pressure and lipid management, and medication reviews. Communicating openly about your symptoms—whether they are physical or emotional—ensures you get the proactive, individualized care you need.