ArticleJournal of neurology2024
Multiple sclerosis in the elderly: a retrospective cohort study.
Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Dementia in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis.Brain and behavior · 2025Pooled it
- The impact of age on efficacy and safety of disease modifying treatment-insights from the Austrian Multiple Sclerosis Treatment Registry.Journal of neurology · 2026Observational
- [XVII Post-ECTRIMS Meeting: Review of the New Developments Presented at the 2024 ECTRIMS Congress (II)].Revista de neurologia · 2026Review
- Adult-onset and late-onset multiple sclerosis in older adults in a Finnish university hospital.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Modulation of the immunological and neuroinflammatory microenvironment in older people with multiple sclerosis.Frontiers in immunology · 2026Review
- Medication Use in Multiple Sclerosis: A Population-Based Comparison With the General Danish Population.Annals of clinical and translational neurology · 2025Article
- Age-related differences in switching highly effective disease-modifying therapy in patients with multiple sclerosis.Journal of neurology · 2025Article
- Advancing multiple sclerosis management in older adults.Nature reviews. Neurology · 2025Article
- Multiple Sclerosis After the Age of 50 Years: A Comparative Analysis of Late Onset and Adult Onset.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients-A Comprehensive Review.Journal of clinical medicine · 2024Review
- The overall and smoking-attributable burden of multiple sclerosis among older adults aged 65-89 years from 1990 to 2019 and predictions to 2040.Frontiers in medicine · 2024Article
Corrections and comments
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Authors and funding
25 authors at 10 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a lack of knowledge of disease course, prognosis, comorbidities and potential treatments of elderly MS patients.
objectiveTo characterize the disease course including disability progression and relapses, to quantify the use of DMTs and to identify comorbidities and risk factors for progression in elderly multiple sclerosis (MS) patients.
methodsThis is a retrospective study of 1200 Austrian MS patients older than 55 years as of May 1st, 2017 representing roughly one-third of all the MS patients of this age in Austria. Data were collected from 15 MS centers including demographics, first symptom at onset, number of relapses, evolvement of disability, medication, and comorbidities.
resultsMedian observation time was 17.1 years with 957 (80%) relapsing and 243 (20%) progressive onsets. Average age at diagnosis was 45 years with a female predominance of 71%. Three-hundred and twenty-six (27%) patients were never treated with a DMT, while most treated patients received interferons (496; 41%) at some point. At last follow-up, 420 (35%) patients were still treated with a DMT. No difference was found between treated and never-treated patients in terms of clinical outcome; however, patients with worse disability progression had significantly more DMT switches. Pyramidal onset, number of comorbidities, dementia, epilepsy, and psychiatric conditions as well as a higher number of relapses were associated with worse outcome. The risk of reaching EDSS 6 rose with every additional comorbidity by 22%. In late and very-late-onset MS (LOMS, VLOMS) time to diagnosis took nearly twice the time compared to adult and early onset (AEOMS). The overall annualized relapse rate (ARR) decreased over time and patients with AEOMS had significantly higher ARR compared to LOMS and VLOMS. Four percent of MS patients had five medications or more fulfilling criteria of polypharmacy and 20% of psychiatric drugs were administered without a matching diagnosis.
conclusionsIn this study, we identified number of comorbidities, pyramidal and cerebellar signs, and a higher number of relapses as unfavorable prognostic factors in elderly MS patients filling gaps of knowledge in patients usually underrepresented in clinical trials and may guide future therapeutic studies.
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