Late-Onset MS
There’s evidence that the age of onset of MS has shifted forward over the past five decades. Researchers say that a rise in the incidence of late-onset MS might be due to more awareness and improvement of diagnostic tools. Still, the time needed to diagnosis late-onset MS is almost double that of adult early-onset MS.
One study comparing late-onset MS in pediatric- and adult-onset MS found that late onset affected a higher proportion of males and was associated with the longest diagnostic delay, highest comorbidity rates, and a greater level of disability. The median EDSS score was highest in the late-onset group.
People with late-onset MS frequently have primary-progressive MS, and if they have RRMS, they face an earlier conversion to secondary-progressive MS compared with those diagnosed at a younger age. Onset at age 50 tripled the risk of developing SPMS versus onset at age 20.
For equivalent disease duration, late onset has been associated with a higher EDSS score: one study found that once EDSS 4 is reached – significant disability but you can walk without aid or rest for 500 meters – age at disease onset was the only predictor of progression of irreversible disability. In a study of over 81,000 people with MS, those with late-onset and very late-onset MS exhibited a more progressive form of disease at onset and higher disability milestones than people with adult-onset MS.
Research has shown that a diagnosis of MS after age 50 is significantly associated with a higher risk of reaching an irreversible EDSS 6 – requiring a walking aid to walk about 100 meters with or without resting – in a shorter time than patients with a younger age at onset.
Mental and physical changes associated with aging can be similar to, or overlap with, symptoms of MS. Such symptoms may include muscle weakness, balance problems, fatigue, visual changes, cognitive impairment (such as problems thinking and remembering), and sleep disturbances.
The combination of aging and MS-related symptoms can exacerbate any of the health problems a person has. For instance, people with mobility problems due to MS may have difficulty traveling to and from healthcare appointments, so they may forgo these trips and miss needed care — for both their MS and other medical conditions.
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