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Age-Related Disability Outcomes After a First Demyelinating Event

  • 0Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain.
Neurology +

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February 4, 2025

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February 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Older adults (40-50) with a first demyelinating event in multiple sclerosis (MS) show less inflammation but higher neurodegeneration risk. This highlights age as a crucial factor in MS progression and disability.

Area Of Science

  • Neurology
  • Neuroimmunology
  • Clinical Research

Background

  • Disability accumulation in multiple sclerosis (MS) can begin early.
  • Aging is a significant factor in MS progression and disability.
  • Early detection of MS progression is crucial for management.

Purpose Of The Study

  • To investigate the prognostic impact of age at first demyelinating event (FDE) on MS progression.
  • To analyze various disability outcomes in different age groups.
  • To assess age-specific differences in inflammatory and neurodegenerative markers.

Main Methods

  • Prospective cohort study of 1,170 patients aged 18-50 years since 1994.
  • Categorization into three age groups: 18-29, 30-39, and 40-50 years.
  • Comparison of relapse-associated worsening, relapse rates, EDSS trajectories, and Cox regression analyses for multiple outcomes including PIRA and CDA.

Main Results

  • The 40-50 age group had higher relapse-associated worsening at FDE and greater annual EDSS increase.
  • This older group showed lower risk for inflammatory outcomes (relapses, new lesions) but higher risk for confirmed disability accumulation (CDA) and progression independent of relapse activity (PIRA).
  • Patient-reported outcomes related to function and well-being were more affected in the 40-50 group.

Conclusions

  • Patients experiencing FDE at 40-50 years present with less inflammatory disease activity compared to younger individuals.
  • Despite lower inflammatory markers, older patients face a higher risk of neurodegenerative outcomes.
  • Age is a critical determinant of MS disease course and disability accrual.