Shift of multiple sclerosis onset towards older age

Area of Science:

• Neurology
• Epidemiology

Background:

• Updated diagnostic criteria for multiple sclerosis (MS) aim to shorten the interval between initial demyelinating events and diagnosis.
• Temporal trends in MS onset characteristics require ongoing investigation.

Purpose of the Study:

• To investigate changes in age at onset and the time from initial demyelinating event to MS diagnosis over time.
• To explore demographic and clinical features associated with different age-onset classes.

Main Methods:

• A multicentre, retrospective study of 4345 patients with relapsing-onset MS in Italy.
• Analysis of temporal trends in age at onset and diagnostic interval, stratified by year of MS onset.
• Exploration of female-to-male ratio and onset location across age at onset categories.

Main Results:

• Mean age at onset for MS significantly increased over time (p<0.0001).
• Mean interval from onset to diagnosis significantly shortened over time (p<0.0001).
• Increased MS onsets observed in older age groups (40-49, 50-59, ≥60 years).
• In patients aged ≥40 years at onset, a higher female-to-male ratio and a predilection for spinal cord onset were noted.

Conclusions:

• Multiple sclerosis onset is shifting towards older age groups.
• These findings necessitate re-evaluation of disease-modifying treatments and care standards for older MS patients.