Management of multiple sclerosis in older adults: review of current evidence and future perspectives

Area of Science:

• Neurology
• Geriatrics
• Immunology

Background:

• The global prevalence of multiple sclerosis (MS) and its aging patient population is rising.
• Older adults with MS (OAMS) are an underrepresented demographic in current medical literature.
• Understanding the unique needs of OAMS is crucial for effective management.

Purpose of the Study:

• To examine the evolving demographics, disease course, and treatment considerations for OAMS.
• To identify and address critical knowledge gaps in the management of OAMS.
• To inform clinical practice and guide future research for OAMS.

Main Methods:

• This narrative review synthesizes existing literature on OAMS.
• It analyzes demographic trends, disease progression patterns, and therapeutic interventions.
• Key areas of focus include comorbidities, immune system changes, and neurodegeneration in OAMS.

Main Results:

• OAMS present distinct clinical challenges compared to younger MS patients.
• Factors such as comorbidities, aging immune system, and reduced neurological reserve necessitate tailored care.
• The benefit-risk profile of disease-modifying therapies (DMTs) requires careful evaluation in older individuals.

Conclusions:

• Significant knowledge gaps persist in understanding and managing OAMS.
• Holistic care approaches are essential, considering wellness and potential DMT cessation.
• Further research is critical to ensure evidence-based, high-quality care for the growing OAMS population.