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Updated: Aug 20, 2025

Author Spotlight: Creating a Versatile Experimental Autoimmune Encephalomyelitis Model Relevant for Both Male and Female Mice
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Sex and age differences in the Multiple Sclerosis prodrome.

Fardowsa L A Yusuf1,2, José M A Wijnands1, Mohammad Ehsanul Karim2,3

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Healthcare utilization before multiple sclerosis (MS) onset varied by sex and age. Differences in genitourinary visits, vertigo prescriptions, and injury-related hospitalizations highlight distinct MS prodrome patterns.

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Multiple Sclerosisagehealthcare useprodromalsex

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Area of Science:

  • Neurology
  • Epidemiology
  • Health Services Research

Background:

  • The prodromal phase of multiple sclerosis (MS) is poorly understood, particularly regarding sex and age variations.
  • Investigating healthcare utilization during the MS prodrome can reveal differences in presentation.

Purpose of the Study:

  • To examine sex and age-specific differences in healthcare utilization in the five years preceding a multiple sclerosis diagnosis.
  • To identify potential heterogeneity in the MS prodromal phase based on demographic factors.

Main Methods:

  • A population-based matched cohort study in British Columbia, Canada, involving over 6,800 MS cases and 31,000 controls.
  • Analysis of administrative and clinical data, comparing healthcare utilization (physician visits, hospitalizations, prescriptions) between MS cases and controls across different sex and age groups.
  • Utilized negative binomial and modified Poisson models to assess relative rates of healthcare utilization.

Main Results:

  • Males with MS showed higher rates of genitourinary visits and antivertigo prescriptions.
  • Older adults (≥50 years) had more injury and infection-related hospitalizations, while younger individuals (<50 years) had more sensory and cardiovascular-related visits.
  • General practitioner visits were more frequent in males and older adults, with ophthalmologist visits disproportionally higher in those under 50.

Conclusions:

  • Significant sex and age-specific differences in healthcare utilization exist in the MS prodrome.
  • These findings underscore the heterogeneous nature of the multiple sclerosis prodromal presentation, suggesting varied pathways to diagnosis.