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Multiple sclerosis among first- and second-generation immigrant groups in Sweden

Wändell, Per LU ; Fredrikson, Sten ; Carlsson, Axel C. ; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2020) In Acta Neurologica Scandinavica 142(4). p.339-349
Abstract

Objectives: Risk of multiple sclerosis (MS) is low among first-generation immigrants in Sweden. We aimed to study incident MS in first- and second-generation immigrant groups. Materials & Methods: We included adults aged 18 years and older in Sweden in first-generation (n = 6 042 891) and second-generation (n = 4 860 469) sub-studies. MS was defined via two diagnoses in the Swedish National Patient Register. MS risk was estimated by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI), in different immigrant groups, using Swedish-born as referents in first-generation sub-study, and individuals with Swedish-born parents in the second-generation. Full models were adjusted for age, geographic residence in Sweden,... (More)

Objectives: Risk of multiple sclerosis (MS) is low among first-generation immigrants in Sweden. We aimed to study incident MS in first- and second-generation immigrant groups. Materials & Methods: We included adults aged 18 years and older in Sweden in first-generation (n = 6 042 891) and second-generation (n = 4 860 469) sub-studies. MS was defined via two diagnoses in the Swedish National Patient Register. MS risk was estimated by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI), in different immigrant groups, using Swedish-born as referents in first-generation sub-study, and individuals with Swedish-born parents in the second-generation. Full models were adjusted for age, geographic residence in Sweden, educational level, marital status, neighborhood socioeconomic status, and co-morbidity. Results: MS was diagnosed among 10 746 individuals in the first-generation sub-study, (men 3055 and women 7691), and 11 737 in the second-generation sub-study (men 3549 and women 8188) in the period 1998-2015. The annual incidence rate was higher in Swedish-born compared to foreign-born, 11.5 vs 6.3 per 100 000 person-years (age-standardized to the European standard population). Fully adjusted HRs were lower in first-generation immigrant men (HR 0.72, 0.64-0.82) and women (HR 0.67, 0.62-0.73), and in second-generation immigrant men (HR 0.88, 0.79-0.97) and women (HR 0.79; 0.73-0.84). Among first-generation immigrants, lower HRs were found in most groups. Significance: The MS risk was lower in first- and second-generation immigrants compared to Swedish-born or individuals with Swedish-born parents.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gender, immigrants, multiple sclerosis, neighborhood, socioeconomic status
in
Acta Neurologica Scandinavica
volume
142
issue
4
pages
11 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:32648932
  • scopus:85088313739
ISSN
0001-6314
DOI
10.1111/ane.13314
language
English
LU publication?
yes
id
1c91431d-11ad-485c-86db-f6c69ccb1e80
date added to LUP
2021-01-26 13:24:48
date last changed
2024-06-14 09:24:05
@article{1c91431d-11ad-485c-86db-f6c69ccb1e80,
  abstract     = {{<p>Objectives: Risk of multiple sclerosis (MS) is low among first-generation immigrants in Sweden. We aimed to study incident MS in first- and second-generation immigrant groups. Materials &amp; Methods: We included adults aged 18 years and older in Sweden in first-generation (n = 6 042 891) and second-generation (n = 4 860 469) sub-studies. MS was defined via two diagnoses in the Swedish National Patient Register. MS risk was estimated by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI), in different immigrant groups, using Swedish-born as referents in first-generation sub-study, and individuals with Swedish-born parents in the second-generation. Full models were adjusted for age, geographic residence in Sweden, educational level, marital status, neighborhood socioeconomic status, and co-morbidity. Results: MS was diagnosed among 10 746 individuals in the first-generation sub-study, (men 3055 and women 7691), and 11 737 in the second-generation sub-study (men 3549 and women 8188) in the period 1998-2015. The annual incidence rate was higher in Swedish-born compared to foreign-born, 11.5 vs 6.3 per 100 000 person-years (age-standardized to the European standard population). Fully adjusted HRs were lower in first-generation immigrant men (HR 0.72, 0.64-0.82) and women (HR 0.67, 0.62-0.73), and in second-generation immigrant men (HR 0.88, 0.79-0.97) and women (HR 0.79; 0.73-0.84). Among first-generation immigrants, lower HRs were found in most groups. Significance: The MS risk was lower in first- and second-generation immigrants compared to Swedish-born or individuals with Swedish-born parents.</p>}},
  author       = {{Wändell, Per and Fredrikson, Sten and Carlsson, Axel C. and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0001-6314}},
  keywords     = {{gender; immigrants; multiple sclerosis; neighborhood; socioeconomic status}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  pages        = {{339--349}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Neurologica Scandinavica}},
  title        = {{Multiple sclerosis among first- and second-generation immigrant groups in Sweden}},
  url          = {{http://dx.doi.org/10.1111/ane.13314}},
  doi          = {{10.1111/ane.13314}},
  volume       = {{142}},
  year         = {{2020}},
}