[Age-related aspects of multiple sclerosis]

To evaluate the epidemiology and clinical features of multiple sclerosis (MS) patients in late adulthood and old age.

MS registry data from the Scientific and Educational Center for the Study of Demyelinating Diseases at Yaroslavl State Medical University were analyzed over a 12-year period. The study included 25 patients with MS onset at age 50 or older, for whom detailed information was available. The comparison group comprised 20 patients with MS onset before age 30.

Secondary-progressive MS was more prevalent among patients with late-onset disease. Motor disorders were significantly more common as initial symptoms in this group (48% vs. 15%, p=0.02). Patients with late-onset MS were also more likely to have a walking distance of less than 120 meters than the comparison group (48% vs. 15%, p=0.02). Although spinal cord lesions were more frequent in patients with late-onset MS (72% vs 55%, p=0.24), the difference was not statistically significant. There was also a trend toward lower effectiveness of first-line disease-modifying therapy (DMT) in patients with late MS onset.

Key areas for optimizing patient management include revising diagnostic criteria for MS in older adults, investigating the effects of DMT in the context of age-related comorbidities, identifying laboratory markers of neurodegeneration, seeking therapeutic targets for pathogenetic therapy in late-onset cases, and developing practical guidelines for DMT use across different age groups.