Features of Multiple Sclerosis in Older Patients in South Wales

Abstract

Multiple sclerosis (MS) may occur outside the commonly accepted age range. Data relating to features of MS in a population in South Wales have been analysed to find features which characterise older patients. The older patients are more severely disabled due to the accumulation of visual defects and motor signs and symptoms. The course of the disease is marked by single localised attacks with long remissions. Those with onset over 50 years deteriorate more rapidly, but in those who were over 50 at the time of interview, this did not occur. It is suggested that there is no essential difference in MS in older patients, but there may be features which reflect normal ageing and diseases commoner in old age.

Late onset multiple sclerosis: concerns in aging patients

“…Interestingly, very late onset MS (defined as the first symptom at 60 years or above), represented 0.27% of our cohort. This figure is lower when compared to other series, which reported a prevalence of 0.45% to 1.33% 2,3,5,9,12,17 . A possible explanation for this finding is the fact that Brazilians may die of other causes before a diagnosis of MS can be made, or since MS is not a common disease in Brazil, the correct diagnosis might be delayed or never made.…”

“…We observed the same frequency of 4.18%, among patients with MS 2,3,4,5,7 ; a female predominance of 2.1:1 1,2,4,7,12,14 , a Caucasian preponderance 12 ; a similar age of onset 2,4,7,11,14 and a higher percentage of the primary progressive form, that reached up to 83% in some descriptions 1,2,4,7,9,11,14,17,21 . Interestingly, very late onset MS (defined as the first symptom at 60 years or above), represented 0.27% of our cohort.…”

“…Different studies reported a similar low annual relapse rate in the late onset RRMS group, compared to the young onset RRMS group, in spite of a shorter interval between the first and second relapse. This low annual relapse rate in older patients could be attributed to a more inflammatory disease in young patients 1,3,12,18,23,27,28 . Recovery after the first relapse is better in younger patients and the chances of full recovery after a relapse decreases by 1% for each year older the patient is at onset 9,25 .…”

“…Therefore, an uncommon form of MS is one in which symptoms start at 50 plus years of age, called late onset multiple sclerosis (LOMS) 1,2,3,4,5,6,7,8 . It accounts for 1.4% to 9.9% of the MS population in different countries 2,4,5,7,9,10,11,12 .…”

eae36, a Locus on Mouse Chromosome 4, Controls Susceptibility to Experimental Allergic Encephalomyelitis in Older Mice and Mice Immunized in the Winter

“…However, lateonset MS, defined as the first presentation of clinical symptoms after 50, has been reported to be in the range of 1.1-10.0% (Noseworthy et al 1983;Marra 1984;Safran 1989;White et al 1990;Azzimondi et al 1994;Polliack et al 2001;Delalande et al 2002). Importantly, a number of studies (Noseworthy et al 1983;Hooge and Redekop 1992;Azzimondi et al 1994;Trefouret et al 1996;Polliack et al 2001;Delalande et al 2002), albeit not all (White et al 1990), report a poorer prognosis and a more rapid progression to disability in late-onset MS patients compared to younger patients. This suggests that late-onset MS may represent a phenotypically and genotypically distinct subset of patients.…”