MS in Older Adults: Why Age at Onset Matters

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Key Takeaway

Older adults with MS often have different disease types and treatment needs, so care should be personalized based on when symptoms first began.

What They Found

Researchers looked at people with MS aged 65 and older and compared those whose symptoms started at age 50 or later (late-onset) to those who developed symptoms between 18 and 49 (adult-onset). They found that the primary progressive form of MS, which slowly gets worse over time without clear attacks, was much more common in the late-onset group (about 4 in 10) than in the adult-onset group (about 1 in 8). For people who had the relapsing type earlier in life, only a quarter or so had used disease-modifying medicines, and some still had occasional relapses after age 65 (more often in the late-onset group). People with late-onset MS stopped disease-modifying medicine at an older age than those with adult-onset, suggesting doctors may treat them longer. After age 65, disability scores were similar between the groups, meaning overall disability level in older age did not differ much by when MS began.

Who Should Care and Why

People with MS and their caregivers should care because the type of MS and treatment choices can change with age and with the age when MS first started; this affects daily routines, medication decisions, and planning for care. Doctors and nurses should pay attention because late-onset MS more often follows a slowly worsening course (primary progressive), which may need different care than relapsing forms—like focusing more on symptom management and mobility support rather than preventing attacks. Caregivers may need to plan for steady needs (for example regular help with walking or household tasks) rather than episodic flare-ups. Older adults who had relapsing MS earlier should watch for occasional relapses even after 65, so staying in contact with healthcare teams remains important. This study suggests care should be tailored—like choosing the right medicines, physical therapy, or home help—based on a person’s MS type and when their symptoms began.

Important Considerations

This study looked back at medical records from one hospital, so results might not be exactly the same in other places or groups of people. The number of late-onset patients was smaller, so some findings (like relapse rates) are less certain and should be taken cautiously. Also, the study can show patterns but cannot prove cause and effect, so any treatment changes should be discussed with a doctor who knows the individual’s full health situation.

Categories:

Living with MS MS Progression MS Diagnostics

Article Topics:

AgedClinical courseMultiple sclerosisOnset ageRetrospective studies

Whether you’ve recently been diagnosed with Multiple Sclerosis (MS) or are seeking to broaden your understanding of this complex, neurodegenerative disease, navigating the latest research can feel overwhelming. Studies published in respected medical journals like Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology often range from early-stage, exploratory work to advanced clinical trials. These evidence-based findings help shape new disease-modifying therapies, guide symptom management techniques, and deepen our knowledge of MS progression.

However, not all research is created equal. Some clinical research studies may have smaller sample sizes, evolving methodologies, or limitations that warrant careful interpretation. For a more comprehensive, accurate understanding, we recommend reviewing the original source material—accessible via the More Details section above—and consulting with healthcare professionals who specialize in MS care.

By presenting a wide range of MS-focused studies—spanning cutting-edge treatments, emerging therapies, and established best practices—we aim to empower patients, caregivers, and clinicians to stay informed and make well-informed decisions when managing Multiple Sclerosis.

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