Objective:

To evaluate long-term trends in MS prevalence, disability-adjusted life years (DALYs), and mortality in the U.S. from 1990 to 2023, stratified by age and sex.

Background:

Despite therapeutic breakthroughs, the real-world burden of multiple sclerosis (MS) in the United States remains poorly characterized. The Global Burden of Disease (GBD) 2023 dataset provides a comprehensive opportunity to reassess national trends in MS morbidity and mortality over the past three decades.

Design/Methods:

Data on MS were extracted from the GBD 2023 database. Age-standardized rates (ASR) per 100,000 population for prevalence, DALYs, and deaths were analyzed. Temporal changes were quantified using percentage change and average annual percent change (AAPC) derived from Joinpoint regression.

Results:

Between 1990 and 2023, U.S. MS prevalence increased by 61.3%, from 94.8 to 152.9 per 100,000, while MS-related deaths rose from 0.91 to 1.42 per 100,000 (AAPC +1.2%/year; p<0.001). Total DALYs increased from 88,210 to 127,640, reflecting a growing disability burden despite improved survival. Women consistently accounted for nearly threefold higher rates than men (ASR 218.6 vs 74.5 in 2023). The steepest rise in prevalence occurred among adults aged 45–64 years.

Conclusions:

The U.S. continues to experience a rising MS burden despite therapeutic advances. Increasing prevalence and disability, particularly among middle-aged women, underscore the need to expand preventive, rehabilitative, and long-term care strategies beyond pharmacologic management. These findings reflect a silent but significant shift in the nation’s neurological disease landscape.