What are the differences between people who develop MS earlier in life and those who develop it later?
UK MS Register researcher Sarah Knowles has recently had a paper published which looks at MS when it develops in older adults compared to younger adults. Late onset MS, or ‘LOMS’, is often defined as MS that is diagnosed after 50 years old and is reported by 9.4% of our website (portal) population.
The paper, published in the prestigious peer-reviewed medical journal Annals of Neurology found that MS looks different when it develops in the later stages of life. Some key findings were that people with LOMS:
- are more likely to be men
- are more likely to have primary progressive MS, meaning symptoms and disability get worse over time from the beginning, rather than relapsing and remitting
- are more disabled at diagnosis
- become more disabled more quickly after diagnosis
- are more likely to have motor symptoms (problems with walking)
- are less likely to be treated with strong MS medications
Sarah also looked at whether the definition of LOMS as onset at age 50+ is outdated and if the disease is actually continually influenced by age.
This is exactly what the findings showed – the older people were when they began to show symptoms of MS, the more likely they were to be male, to be primary progressive, and to have motor symptoms.
Sarah also worked with Dr Owain Howell looking at brain samples from people with late onset MS who had died. They found that people with a later onset had:
- less active inflammation and new lesions compared to younger onset MS
- more loss of nerve cells, especially in deep brain regions, compared to younger onset MS
In summary, late onset MS in older adults seems to progress more quickly with faster nerve cell loss, while younger onset MS has more inflammation and relapses. This information may help guide treatment decisions in older MS patients, particularly because current MS drug treatments target inflammation, which is why they may be effective at preventing relapses but less effective at preventing progression. It is important for researchers to look at drugs which target nerve cell loss in order to target progression.
Read Sarah’s full paper here.
Read more about this from the MS Society here.