Persons with multiple sclerosis older than 55 years: an analysis from the German MS registry

J Neurol. 2024 Jun;271(6):3409-3416. doi: 10.1007/s00415-024-12286-4. Epub 2024 Mar 22.

Abstract

Background: Persons with MS (PwMS) ≥ 55 years are underrepresented in therapy studies leading to a lack of evidence.

Objective and methods: To study the subgroup of PwMS ≥ 55 years in the German MS registry in comparison with PwMS < 55 years. Endpoints of interest were the grade of disability, leading symptoms, clinical and magnetic resonance imaging activity, and use of disease modifying therapy.

Results: At the time of analysis, data from 40,428 PwMS were available for analysis. In PwMS aged ≥ 65 and PwMS aged ≥ 55 to 64 years, compared with PwMS aged < 55 years, the mean Expanded Disability Status Scale Scores were higher (5.3, 4.2 and 2.7, respectively), while the proportion of individuals with current use of disease modifying therapy was lower (42.6%, 60.9% and 76.7%, respectively). The older patient groups were more likely to be labeled with progressive MS and the frequency of occupational invalidity was high (38.8% in PwMS aged ≥ 55 to 64 years). Gait disorder, fatigue, bladder dysfunction, and spasticity were among the leading symptoms in PwMS aged ≥ 55 years.

Conclusion: PwMS ≥ 55 years have a high degree of disability, but a large proportion do not receive disease modifying therapy, exposing an unmet need.

Keywords: Age; Disease modifying therapy; Epidemiology; Multiple sclerosis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Disability Evaluation
  • Female
  • Germany / epidemiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / diagnostic imaging
  • Multiple Sclerosis* / epidemiology
  • Registries*