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Late-onset multiple sclerosis.

M L Polliack1, Y Barak, A Achiron

  • 1Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.

Journal of the American Geriatrics Society
|February 24, 2001
PubMed
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Late-onset multiple sclerosis (MS), diagnosed after age 50, is not rare and presents diagnostic challenges. This condition can manifest as depression and shows rapid neurological deterioration, differing from typical MS progression.

Area of Science:

  • Neurology
  • Clinical Medicine

Background:

  • Multiple sclerosis (MS) onset after age 50 is uncommon and poses diagnostic difficulties.
  • Understanding the characteristics of late-onset MS is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the prevalence, clinical presentation, and characteristics of multiple sclerosis (MS) diagnosed in patients over 50 years old.

Main Methods:

  • Retrospective chart review of 640 patients diagnosed with MS.
  • Analysis included age, gender, clinical presentation, disease course, neurological involvement, and Progression Index (PI).
  • Late-onset MS defined as onset after age 50, diagnosed using Poser criteria and confirmed by MRI.

Main Results:

  • 4.6% of patients (30 out of 640) were diagnosed with late-onset MS, with a mean age of onset of 53.5 years.

Related Experiment Videos

  • Motor symptoms were the most frequent initial presentation (63.3%), with 20% experiencing major depressive episodes prior to diagnosis.
  • Patients exhibited a mean PI of 0.81, indicating rapid neurological deterioration, and increased sphincteric and cerebellar involvement over time.

    • Conclusions:

    • Late-onset MS is a significant clinical entity, not as rare as previously thought.
    • Major depression can be an initial symptom of late-onset MS, complicating diagnosis.
    • Despite similar initial neurological symptoms to younger-onset MS, late-onset MS demonstrates faster progression and a higher prevalence of primary progressive disease.