ArticleJournal of neurology2025
Clinical, functional and cognitive features of late-onset multiple sclerosis.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
introductionLate-onset multiple sclerosis (LOMS, onset > 50 years) is increasingly recognized and may differ from adult-onset MS (AOMS).
objectivesTo compare clinical, motor, and cognitive features of LOMS vs. AOMS, and explore the influence of fatigue and depression on cognitive impairment.
methodsIn this case-control study, 41 LOMS patients and 82 disease duration- and sex-matched AOMS patients underwent neurological evaluation (including recording of vascular risk factors), neuropsychological evaluations (including fatigue and depression), and motor function assessment (9-Hole Peg and Timed 25-Foot Walk tests). Group differences were FDR-corrected. Logistic regressions tested associations and interactions of fatigue and depression with cognitive impairment. A p < 0.05 was considered statistically significant.
resultsCompared to AOMS, LOMS patients more frequently presented with motor onset and progressive phenotypes, had higher EDSS, higher prevalence of patients with EDSS ≥ 4, and were less often treated (pFDR ≤ 0.011). No differences emerged in vascular risk factor prevalence and motor task performance. Compared to AOMS, LOMS showed more frequent cognitive impairment (36% vs 17%), with worse performance in attention, verbal fluency, and global cognition (pFDR ≤ 0.049). LOMS patients were also more frequently fatigued (63% vs 32%) and had higher fatigue severity scores (pFDR ≤ 0.033). Depression did not differ between groups. Fatigue was associated with cognitive impairment only in LOMS (OR = 1.13, 95% confidence interval = 1.05-1.22, p = 0.002), with a significant group × fatigue interaction (p = 0.014), independent of age and disability. No association was found between depression and cognitive impairment.
conclusionsLOMS showed a worse clinical and cognitive profile than AOMS, with fatigue playing a significant role in cognitive vulnerability.
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