Late onset multiple sclerosis: concerns in aging patients.

Area of Science:

• Neurology
• Clinical Medicine

Background:

• Late onset multiple sclerosis (LOMS) is defined as initial symptoms appearing after age 50.
• LOMS constitutes approximately 4.5% of all multiple sclerosis (MS) cases.
• Understanding LOMS clinical characteristics is crucial for patient management.

Purpose of the Study:

• To describe the clinical features of patients diagnosed with LOMS.
• To compare the progression of LOMS with early onset MS (EOMS).

Main Methods:

• Retrospective analysis of medical records from 742 MS patients at a specialized center.
• Inclusion criteria focused on patients with LOMS (onset >50 years).
• Matched control group of EOMS patients for comparative analysis.

Main Results:

• LOMS frequency was 4.18% in the studied cohort.
• Median age at LOMS onset was 54 years.
• Primary progressive MS was the predominant course (64.3%) in LOMS patients.
• LOMS patients reached Expanded Disability Status Scale (EDSS) 3.0 (77.42% in 3.7 yrs), 6.0 (58.06% in 5.1 yrs), and 7.0 (32.26% in 5.7 yrs).
• Late onset and progressive course were significant predictors for faster progression to EDSS 3.0 and 6.0 compared to EOMS.

Conclusions:

• LOMS is characterized by a later age of onset and a higher prevalence of the primary progressive form.
• Patients with LOMS experience disability progression more rapidly than those with EOMS.
• Identifying LOMS and its progressive nature is vital for timely therapeutic interventions and management strategies.