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Frailty in ageing persons with multiple sclerosis.

Xavier Ayrignac1, Catherine Larochelle2, Mark Keezer3

  • 1Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada/Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada/Département de Neurologie, CRC sclérose en plaques, CHU Montpellier, INSERM, Université Montpellier, Montpellier, France.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 28, 2020
PubMed
Summary

Older adults with multiple sclerosis (MS) show significantly higher frailty compared to controls. This highlights the need for a multidisciplinary approach to manage aging in persons with MS (pwMS).

Keywords:
Fried’s phenotypeMultiple sclerosisageingcomorbiditiesfrailtyquality of life

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Area of Science:

  • Gerontology
  • Neurology
  • Clinical Medicine

Background:

  • Advances in multiple sclerosis (MS) management have increased life expectancy for persons with MS (pwMS).
  • Aging with MS presents unique challenges impacting quality of life and socioeconomic factors.
  • Understanding the specific health trajectories of aging pwMS is crucial.

Purpose of the Study:

  • To compare frailty levels in aging persons with multiple sclerosis (pwMS) and age-matched controls.
  • To investigate the correlation between frailty and clinical characteristics in pwMS.
  • To assess the prevalence of frailty using validated measures in an aging MS population.

Main Methods:

  • A cross-sectional study design was employed, recruiting pwMS and controls aged over 50.
  • Two validated frailty measures, the frailty index and Fried's phenotype, were utilized.
  • Multivariable linear regression analyses were performed, controlling for demographic and clinical variables.

Main Results:

  • Eighty pwMS and 37 controls were analyzed. PwMS exhibited a significantly higher frailty index (0.21 vs 0.11, p < 0.0001) and a greater percentage of frail individuals (28% vs 8%).
  • In pwMS, the frailty index was independently associated with the Expanded Disability Status Scale (EDSS), number of comorbidities, education level, and disease duration.
  • These findings indicate a clear link between MS progression, overall health status, and frailty in older adults.

Conclusions:

  • Frailty assessment should be considered a routine component of care for persons with MS (pwMS).
  • The increased frailty observed in aging pwMS underscores the necessity of a tailored, multidisciplinary approach beyond standard MS therapeutics.
  • This approach should address the complex needs of aging pwMS to improve their quality of life and reduce socioeconomic burden.