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Age and disability accumulation in multiple sclerosis

A Scalfari1, A Neuhaus, M Daumer

  • 1University Department of Clinical Neurology, Level 3, West Wing, John Radcliffe Hospital, Oxford, UK, OX3 9DU. george.ebers@clneuro.ox.ac.uk

Neurology
|September 16, 2011
PubMed
Abstract

Insights

Age at multiple sclerosis (MS) onset influences disability progression, primarily by affecting the likelihood and timing of developing secondary progressive MS. The disease course itself is less impacted by age.

Area of Science:

  • Neurology
  • Clinical Epidemiology

Background:

  • Multiple sclerosis (MS) prognosis is influenced by various factors, including disease course and patient characteristics.
  • Understanding the role of age in long-term disability accumulation is crucial for predicting MS outcomes.

Purpose of the Study:

  • To investigate whether age serves as a prognostic factor for long-term disability accumulation in multiple sclerosis.
  • To determine the specific impact of age at different disease stages on disability progression.

Main Methods:

  • Kaplan-Meier analysis and binary logistic regression were employed.
  • The study analyzed data from 1,023 patients in the London, Ontario MS database.
  • Key variables included age at disease onset, age at progression onset, and current age, assessed against severe disability levels (Disability Status Scale [DSS] 6-8-10).

Main Results:

  • Older age at the onset of the relapsing-remitting (RR) phase correlated with a higher risk of advanced disability (DSS scores).
  • This association was independent of disease duration and early relapse frequency but linked to an increased risk of conversion to secondary progressive (SP) MS.
  • Onset at 40 or 50 years significantly increased the risk of developing SP MS compared to onset at 20 years. Younger age at SP MS conversion predicted shorter times to severe disability.
  • The progressive course of MS was minimally affected by age at SP onset and unaffected by age at RR onset.

Conclusions:

  • The development of SP MS is the primary determinant of long-term prognosis in MS, irrespective of disease duration or early relapse rates.
  • Age independently influences disability progression by altering the probability and timing of SP MS onset.
  • Age has a limited effect on the progression rate of established SP MS.

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