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Advancing multiple sclerosis management in older adults.

Anneke van der Walt1, Eva M M Strijbis2, Francesca Bridge3

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As people with multiple sclerosis (MS) live longer, managing the condition becomes complex. This consensus statement addresses the unique challenges of aging with MS and provides recommendations for future research and care.

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Area of Science:

  • Neurology
  • Geriatrics
  • Immunology

Background:

  • Multiple sclerosis (MS) diagnosis typically occurs in early to middle adulthood.
  • Advancements in healthcare allow individuals with MS to live longer, with approximately 50% now aged 50 years or older.
  • Aging complicates MS diagnosis, treatment, and management due to physiological changes, immunosenescence, and comorbidities.

Purpose of the Study:

  • To review the current understanding of aging with multiple sclerosis.
  • To identify knowledge gaps in the diagnosis, treatment, and management of MS in older adults.
  • To provide recommendations for future research and clinical practice concerning aging and MS.

Main Methods:

  • Consensus statement based on an International Advisory Committee on Clinical Trials (IACCT) in MS workshop.
  • Review of the current literature and status of research on aging and MS.
  • Identification of unmet needs and formulation of recommendations.

Main Results:

  • Late-onset MS diagnosis requires differentiating from age-associated conditions.
  • Age-related physiological changes can confound disease monitoring (MRI, disability, cognition).
  • Treatment decisions for older adults with MS are challenging due to increased risks and reduced benefits of high-efficacy therapies.

Conclusions:

  • Aging significantly impacts the complexity of multiple sclerosis management.
  • There is a need for more evidence to guide treatment and care for older individuals with MS.
  • Recommendations are provided to advance research and address unmet needs in aging with MS.