Effect of gender on late-onset multiple sclerosis

Area of Science:

• Neurology
• Immunology
• Epidemiology

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Late-onset multiple sclerosis (LOMS), defined as onset after age 50, represents a distinct clinical subgroup.
• Gender and race are known modifiers of MS disease course.

Purpose of the Study:

• To compare the incidence and disease course of LOMS with adult-onset MS (AOMS).
• To investigate the influence of gender and race on MS disease outcomes in LOMS versus AOMS.
• To analyze the time to sustained disability progression in different MS onset groups.

Main Methods:

• Retrospective analysis of a clinic cohort of 4273 patients with MS.
• Comparison of demographic and disease course characteristics between LOMS and AOMS groups.
• Logistic regression for combined effects and interval-censored log-rank test for time to EDSS 6.

Main Results:

• LOMS accounted for 7.96% of cases, with 1.33% having onset after age 60.
• Progressive onset was more frequent in LOMS compared to AOMS.
• Time to Expanded Disability Status Scale (EDSS) 6 was delayed in AOMS females versus males, but similar between genders in LOMS.

Conclusions:

• Women with LOMS exhibit a distinct disease progression trajectory compared to women with AOMS.
• Further research is needed to understand the interplay of menopause, race, and ethnicity in MS disease course.
• These findings highlight potential differences in LOMS management and prognosis.