Multiple sclerosis average age: What Is the Age of Onset for Multiple Sclerosis?

10.10.202317.07.2023 by alexxlab

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What Is the Age of Onset for Multiple Sclerosis?

Typically people are diagnosed with multiple sclerosis (MS) between the ages of 20 and 40, but late-onset MS (LOMS) affects people age 50 and older.
LOMS usually progresses faster than MS diagnosed at a younger age.
There are several steps doctors take before making a diagnosis and determining the best course of treatment.
Treatments, including rehabilitation and medications, can help manage symptoms of MS.

Typically, people are diagnosed with multiple sclerosis (MS) between the ages of 20 and 40, but late-onset MS (LOMS) begins to affect people ages 50 and older. The disease’s progression is usually faster in LOMS.

If you have MS, you’re among the more than 2.3 million people worldwide who share this diagnosis. While there isn’t a cure for the condition, treatments that slow MS’s progression and help to reduce symptoms are available.

MS is a disease of the central nervous system (CNS). With MS, the brain, optic nerves or spinal cord — all part of the CNS — become inflamed. When this happens, the nerves’ protective covering, known as myelin, suffers damage.

This damage shows up in MS symptoms ranging from difficulty concentrating to muscle spasms. There are a number of other symptoms, some more common than others.

There are four disease courses, or stages, of MS development:

Clinically isolated syndrome (CIS). This occurs when symptoms first appear and last for at least 24 hours. Symptoms result from myelin damage in the CNS, but not everyone who gets CIS develops MS.
Relapsing-remitting MS (RRMS). This stage is characterized by attacks, also called relapses, of new or increasing neurological symptoms. Relapses are followed by partial or complete remissions, or recovery.
Secondary progressive MS (SPMS). This begins as RRMS but gradually worsens over time. Not all cases of RRMS will transition into SPMS.
Primary progressive MS (PPMS). This stage is defined by worsening neurologic functions from the time symptoms first appear. LOMS often starts at this most serious stage.

Adult-onset MS (AOMS) is usually diagnosed in adults ages 20 to 40, but MS can also develop in older adults, teens, and, in rare cases, children.

Children with pediatric MS usually have CIS or RRMS. Children with MS tend to recover more quickly than adults who are diagnosed with MS, since full remission or recovery is common in the RRMS stage.

Pediatric MS is hard to diagnose because it’s similar to acute demyelinating encephalomyelitis (ADEM). It can, however, lead to serious disability at an early age.

LOMS, which is when symptoms first appear in adults over the age of 50, accounts for 10 percent of all MS diagnoses.

A late diagnosis sometimes happens when people don’t seek medical attention for mild sensory symptoms.

There are a number of symptoms associated with MS. Symptoms are unpredictable and may change over time. In addition, not everyone who is diagnosed with MS will experience the same symptoms.

Some common symptoms include:

weakness
vision changes
fatigue
loss of balance
bladder dysfunction
difficulty understanding or remembering new information

Other symptoms include:

depression
pain or itching
sexual issues
emotional changes

Typical LOMS symptoms are related to motor dysfunction and visual problems.

There’s no one test used to diagnose MS. Rather, doctors will perform many tests and exams to first rule out other medical conditions.

The following are typical strategies used by healthcare professionals:

Neurological exam. This exam evaluates things like mental status, reflexes, coordination, and sensory function.
Detailed clinical history. This process identifies previous symptoms, other diagnoses, and any information relevant to your health.
Blood tests. These tests can help rule out other medical conditions that may share similar symptoms to MS.
Magnetic resonance imaging (MRI). This scan may detect MS lesions in the brain and spinal cord.
Oligoclonal band screening. This screening checks cerebrospinal fluid (CSF) for oligoclonal-bands (OCBs) — proteins that can indicate the presence of CNS inflammation.
Evoked potential testing. This testing measures how quickly the brain responds to sight, sound, and touch stimulation.

To assess MS progression, doctors sometimes use the Expanded Disability Status Scale (EDSS). This scale ranges from 0 (normal neurological exam with no disability in any functional system) to 10 (death from MS). A 2016 study in PLOS One found that people with LOMS reached a 6.0 on the EDSS faster than those with AOMS.

This study looked at people over age 40 in its analysis of people with LOMS.

People who are diagnosed with MS as young adults are most likely to be diagnosed with RRMS. This is the most common disease course with around 85 percent of people with MS determined to have this type.

There are treatments available to help you manage symptoms of MS.

Rehabilitation can help to improve your energy, memory, and mobility. Types of rehabilitation your doctor may recommend include:

physical rehab to work on improving balance, strength, and range of motion
cognitive rehab to help with communication, organization, and attention
occupational rehab for self-management and self-care, including doing chores and enjoying hobbies

Medications, called disease modifying therapies (DMTs), may also be used to treat MS. DMTs work to reduce the amount of relapses and slow the course of the condition.

Everyday symptoms, such as fatigue or bladder and bowel issues, are typically managed with other types of medications — not DMTs. A healthy lifestyle can also address MS symptoms and improve overall quality of life.

Your doctor will create a treatment plan based on how far your MS has progressed and how old you are at its onset.

MS is most often diagnosed between 20 and 40 years of age, but LOMS is usually diagnosed after the age of 50. Disease progression may be faster in LOMS, since it’s often diagnosed as PPMS, the most serious stage of the disease.

Your doctor’s goal is to reach an accurate diagnosis after tests including a neurological exam, clinical history, MRI, OCB screening, and evoked potential testing. After the diagnosis, you and your doctor can decide on a treatment plan that’s right for you.

What Is the Average Age for a Multiple Sclerosis Diagnosis?

Connect with others living with multiple sclerosis

Resources
MS Information
Diagnosis and Testing

Medically reviewed by
Evelyn O. Berman, M.D.

Article written by
Anastasia Climan, RDN, CDN

A person can develop multiple sclerosis (MS) at any age, but the condition is most often diagnosed in adults ages 20 to 50. Some health care experts estimate the average age of diagnosis is 34. Regardless of age group, however, everyone faces unique challenges on the path to diagnosis.

Although scientists have yet to discover a clear cause of MS, they’ve identified risk factors including biological sex, environmental factors, geographical location, and race and ethnicity. Currently, there are about one million people living with MS in the United States.

Here’s what members of MyMSTeam have shared and what the experts say about diagnosis during different stages of life.

Childhood MS Prevalence and Symptoms

Scientists estimate that 3 percent to 5 percent of MS cases develop in people under the age of 16. MS in children and adolescents under 18 is referred to as pediatric MS, or pediatric-onset MS (POMS). In children under 12, the female to male ratio for the incidence of an MS diagnosis is 1.2-to-1. For children over the age of 12, the ratio difference is higher, at 2.8 females per every male diagnosed.

MS affects children differently from adults in some key ways. During the first six years of POMS, children experience relapses (return of symptoms) two to three times more frequently than adults with early MS, according to the National Multiple Sclerosis Society. However, children also tend to recover more quickly and develop disabilities at a slower rate than adults.

Sometimes adults with MS recall experiencing unusual symptoms in their early years which they hadn’t realized resulted from having the condition. Teenagers may have mild symptoms of MS that fly under the radar, and they end up going undiagnosed until adulthood.

Such was the case for one MyMSTeam member, who said, “It took 19 long years to diagnose my MS. I was 16 (1976) when it started. My relapses were so far apart in the beginning, but as the years went by, my relapses became closer together, and more symptoms cropped up. The year my son was born (1990) was when some of the worse symptoms started, and doctors were able to rule out other illnesses. I was diagnosed in 1995.”

Diagnosis of MS in Adulthood

People who experience unusual or unexplained symptoms as teenagers may notice that those symptoms are worse or more frequent in adulthood, particularly when life gets busy or stressful. These worsening symptoms can sometimes be the trigger that leads to an MS diagnosis.

“I kept dropping things when I made dinner, and my balance was off while walking,” one MyMSTeam member wrote. “During that time, I was under a lot of stress at home and work. I made an appointment with my primary doctor, who recommended an MRI. The results showed a bunch of lesions in my brain and spinal cord.”

MS is considered the most common cause of nontraumatic neurological disability in adults. When it comes to types of MS and age, relapsing-remitting MS (RRMS) makes up 80 percent of MS cases for people aged 20 to 40. Most people with adult-onset MS develop secondary progressive MS during the disease course as they age, but 30 percent continue to have RRMS while they get older.

Getting Diagnosed With MS Later in Life

An MS diagnosis at age 50 or later is considered late-onset MS (LOMS). The average age of LOMS onset is between 53 and 67. Diagnosis after age 60 is considered very late-onset and accounts for only 1 percent of MS cases.

Like pediatric MS, LOMS is rare, representing between 0.6 percent and 12 percent of total MS cases. Although adult MS affects three times more women than men, LOMS is more common in men.

People diagnosed with MS at a later age of onset may have other conditions (called comorbidities) that complicate MS treatment. For example, cognitive impairment — such as trouble with memory, attention span, or decision-making — is often more pronounced. So, too, are vision problems, sensory disturbances, and motor dysfunction.

Fortunately, advances in disease-modifying therapies (DMTs) have helped slow disease progression and increase the life expectancy for people with MS. Talk to your neurologist about which treatments might work for you to potentially slow the progression of MS.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 191,000 members come together to ask questions, give advice, and share their experiences with others who understand life with multiple sclerosis.

If you have MS, when did you first begin to notice symptoms of multiple sclerosis? How long did it take to get an accurate diagnosis? Share your story in the comments below, or start a conversation by posting in the Activities feed.

References

Who Gets Multiple Sclerosis? Epidemiology of MS — National Multiple Sclerosis Society
Pediatric MS — National Multiple Sclerosis Society
Epidemiology of Pediatric-Onset Multiple Sclerosis: A Systematic Review of the Literature — Journal of Child Neurology
Multiple Sclerosis in People Over Age 55 — Practical Neurology
Late-Onset MS: Disease Course and Safety-Efficacy of DMTS — Frontiers in Neurobiology
MS Diagnosis: The Full Guide — Overcoming MS

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Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.

Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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What is multiple sclerosis, signs, stages, treatment

Multiple sclerosis is a chronic disease of the central nervous system. The pathology is based on autoimmune processes of damage to the myelin sheaths of axons. The conduction of nerve impulses is disturbed, characteristic symptoms develop. The disease is treated by a neurologist.

Etiology and causes

It is difficult to name the exact causes of multiple sclerosis – the mechanism for triggering autoimmune processes is unclear. It is only known that a viral infection can become a provoking factor. The microorganism in the human body produces proteins that trigger an abnormal immune response. Autoreactive B- and T-lymphocytes are activated in the lymph nodes.

The disease affects people of all ages and both sexes, but the diagnosis is more often made in young Caucasian women living in countries of northern latitudes.

The myelin sheath of axons plays an important role in the transmission of nerve impulses between cells. In multiple sclerosis, a person’s own immune system partially destroys this structure. Demyelination sites can be located in various parts of the body. In place of damaged cells, a sclerotic plaque is formed from connective tissue, which completely blocks electrical signals. As a result, the main function of nerve fibers is inhibited.

Among the most common causes of multiple sclerosis is heredity. If there are people in the family with neurological diseases or autoimmune pathologies, the risks increase by about 30%. Another 70% are non-genetic factors of multiple sclerosis.

It is important to understand that it is not the disease itself that is inherited, but a predisposition to it. If one of the parents had multiple sclerosis, then in only 2% of cases the child is diagnosed with the same diagnosis. The rest of the babies remain only at an increased risk. That is, other things being equal, the risk of developing the disease in a child with a burdened heredity is higher than in children from healthy parents.

The precipitating factors for multiple sclerosis are:

1. Age. Diagnosis is most often made between the ages of 20 and 40 years. But multiple sclerosis can develop in children and the elderly. The later the debut, the more severe the disease.

2. Infections. The risk of developing multiple sclerosis increases the presence of cytomegalovirus, polyoma and retroviruses, Epstein-Barr virus, which causes mononucleosis.

3. Dysbacteriosis. Oddly enough, but the intestinal microflora directly affects the immune system. It is recognized that bacteria help active defender cells recognize the threat and eliminate it in time. For unknown reasons, sometimes the antigens of intestinal microorganisms provoke autoimmune processes and cause the progress of demyelination. Evidence for the theory comes from animal and human studies.

4. Smoking. Nicotine increases risks and accelerates the destructive action of the immune system.

5. Poor nutrition. Doctors around the world are suggesting that excessive consumption of saturated animal fats can provoke the development of multiple sclerosis.

Symptoms of multiple sclerosis

Manifestations of the disease are individual. The nature of the symptoms depends on the location and degree of destruction of nerve fibers.

A sign of multiple sclerosis can be:

numbness, weakness in the limbs;
difficulty in moving;
reflex disorders;
decreased visual acuity for no apparent reason;
unsteady gait;
double vision, dizziness;
increased muscle tone;
change in the nature of speech: it may become slow;
increased fatigue and weakness;
emotional instability;
urination disorder, etc.

The first symptoms may appear at a young age, in 20-40 years. In the early stages of multiple sclerosis, patients rarely pay attention to warning signs, continue to live and work in the same rhythm. Periods of exacerbations are replaced by remissions, sometimes without taking medications. Several years may elapse between episodes of the disease. Gradually, the intervals decrease. When the disease progresses, the person himself notices changes in his condition and consults a doctor. Severe symptoms of multiple sclerosis reduce the quality of life.

In medical practice, there are cases of rapid progression. Early multiple sclerosis in just a few years goes into advanced stages. The loss of motor activity progresses constantly and leads to disability, while other patients with the same debut continue to lead a full life in society.

Forms of multiple sclerosis

Allocate:

1. Clinically isolated syndrome (CIS). This is a harbinger of multiple sclerosis. A clinically isolated syndrome is the manifestation of one or more neurological symptoms for 24 hours or longer.

2. Relapsing-remitting form of multiple sclerosis. The period between exacerbations lasts for years and even decades. At the same time, disability is steadily increasing. The relapsing form inevitably progresses. Sometimes it is short or completely absent.

3. Secondary progressive form of multiple sclerosis. The disease develops within a few years after the establishment of remitting pathology. In every second case, the secondary progressive form occurs 10 years after the onset of symptoms. 30 years after relapsing-remitting multiple sclerosis in 90% of patients are diagnosed with transition to this stage. The disease is characterized by a severe course with a constant increase in symptoms.

4. Primary progressive form of multiple sclerosis. Pathology is severe from the very beginning, without remissions, leads to rapid disability.

Diagnostics

The disease has no specific symptoms. At an early stage of multiple sclerosis, the examination of the patient does not reveal any pathologies. Inexperienced professionals often conclude that unusual symptoms are caused by overwork or the emotional state of the patient. Retrospective assessments show that every second patient has been ill for at least 5 years by the time of visiting a doctor.

Any of the clear signs of multiple sclerosis can be observed in other pathologies of the nervous system. Therefore, it is important to conduct a differential diagnosis with an experienced specialist.

The complex of surveys includes:

1. MRI of the brain and spinal cord. The images show damaged areas of nerve fibers. For better detail, an MRI with contrast is performed. If there are no plaques on the tomogram, but the patient is diagnosed with a clinically isolated syndrome, then the risk of developing multiple sclerosis is low.

2. CSF analysis. Puncture to collect cerebrospinal fluid. With multiple sclerosis, myelin breakdown products are found in the cerebrospinal fluid. The results of the analysis are not sufficient for an unambiguous diagnosis, but are necessary for a comprehensive assessment of the clinical picture.

3. Dopplerography of vessels. Investigation is necessary to exclude other diseases with neurological symptoms.

4. Analysis of evoked potentials. Clarifying diagnostic method based on measuring the electrical activity of neurons in response to stimulation of specific nerve pathways. The analysis allows you to establish a violation of the conduction of the impulse caused by changes in the shells of axons.

5. Blood tests. Results are needed to rule out infectious diseases and autoimmune conditions that can affect the functioning of the nervous system.

To make an accurate diagnosis, the doctor needs to detect signs of demyelination in two different areas of the central nervous system (scattering), confirm plaque formation at different times, and exclude other possible neurological diseases. Therefore, according to the results of the first examination, the specialist writes assumptions. The final diagnosis is made after the discovery of new plaques on repeated images, which are taken at intervals of 6 months.

Treatment

Medical treatment

Therapy for multiple sclerosis is aimed at reducing the activity of the immune system in terms of attacks on the sheaths of nerve fibers. The doctor prescribes medicines in the form of injections or tablets. Modern drugs help to stop the processes of neurodegeneration and significantly increase the life expectancy of the patient. The earlier treatment of multiple sclerosis is started, the better the prognosis. In advanced cases, a persistent neurological deficit develops, which is not amenable to therapy and leads to disability.

More than 10 drugs have been approved for the treatment of multiple sclerosis in the world, conditionally divided into 4 groups:

1. Immunomodulating agents. Active substances inhibit the activation of autoreactive lymphocytes.

2. Selective drugs. The drug binds to receptors on lymphocytes and prevents them from leaving the lymph nodes.

3. Humanized monoclonal antibodies. The drugs prevent the penetration of autoreactive lymphocytes to the focus of inflammation.

4. Immunosuppressants. Suppress the activity of the immune system.

The effectiveness of drugs against relapsing-remitting and secondary progressive forms of the disease has been proven. Currently, research is underway on drugs for the treatment of primary progressive multiple sclerosis. Some drugs are included in the list of vital drugs and are purchased at the expense of the federal budget.

Multiple sclerosis with onset in middle age and without quality treatment for several years can be fatal. The cause of death is usually kidney failure, which develops against the background of recurrent urinary tract infections.

Hemocorrection treatment

The doctor’s goal is to cleanse the blood of immune complexes and decay products of nerve cells.
There are several modern methods of treatment:

1. Immunosorption. Selective method for the removal of immunoglobulins and low density lipoproteins from the blood. The content of other components remains unchanged.

2. Incubation of cell mass. The patient’s own blood structures, pharmacocytes, are used. With the help of cells, drugs are delivered directly to the site of destruction. The method allows to increase the effectiveness of drugs, reduce their dosage, reduce the risk of side effects.

3. Cascade plasma filtration. Viruses, bacteria, toxic substances are selectively removed from the substance, all side elements are preserved. The plasma passes through a special filter system.

4. Cryoapheresis. Semi-selective method based on the ability of large blood plasma molecules to form insoluble compounds and settle under low temperature conditions.

5. Lymphocytopheresis. Lymphocytes, cells of the immune system, are removed from the blood. The method allows you to suppress abnormal reactions without taking drugs and with virtually no side effects.

6. Photopheresis. The blood outside the patient’s body is exposed to ultraviolet radiation at a specific wavelength. Light causes the death of lymphocytes. After that, the blood is returned to the vessels.

Autologous stem cell transplant

One of the new treatments that involves “rebooting” the immune system. Before transplantation, complete destruction of autoreactive lymphocytes is achieved. Then the patient is injected with his own hematopoietic stem cells, the immune system restores protective structures, but without abnormal reactions. The technique cannot affect those changes that have already occurred. But transplantation significantly slows down or completely stops further demyelination.

Treatment is complex, long, requires constant medical supervision. The patient is currently in the hospital. After transplantation, rehabilitation is necessary, which takes several months – until the functions of the immune system are restored.

Over the past 20 years, doctors around the world have made great progress in the treatment of multiple sclerosis. Drugs are being developed that suppress autoimmune inflammation at different stages of development. Cellular technologies help to partially restore the lost functions of the nervous system, while, of course, within the framework of clinical studies.

Diagnosis and treatment of multiple sclerosis in Moscow

Timely and high-quality medical care will help maintain the quality of life in multiple sclerosis for many years. Sign up for a consultation with a neurologist at the MedEx clinic. In our center you will find a comprehensive examination and competent treatment. The doctors of the clinic constantly improve their qualifications, study new drugs and technologies, and help patients achieve the desired results. You can make an appointment through the feedback form or by phone.

May 27 is International Multiple Sclerosis Day

05/27/2022

May 27 is International Multiple Sclerosis Day.

Multiple sclerosis is an inflammatory disease of the central nervous system that can affect several areas of the brain and spinal cord at once. In the world, this disease affects about 2-2.5 million people. The total number of patients with this disease in our country is about 200 thousand. And most of them are young people between the ages of 20 and 40.

Multiple sclerosis, according to WHO, ranks third among diseases of the central nervous system (after vascular diseases and epilepsy). Today, the head of the Center for Consultative Assistance to Patients with Multiple Sclerosis of the CDC, neurologist Olga Anatolyevna Soldatova talks about a complex disease:

– How common is this disease today? How many patients with multiple sclerosis in our region?

О. А.: More than 100 thousand people suffer from multiple sclerosis in Russia, more than 1000 patients are registered in the Omsk region. The average prevalence of the disease is about 60 people per 100,000 population.
The incidence of multiple sclerosis and autoimmune disease is generally increasing worldwide. This is due, among other things, to the development of diagnostic capabilities at the earliest stages. Multiple sclerosis is one of the most common causes of persistent disability in young people.

– Is multiple sclerosis incurable?

O.A.: We do not use the term “incurable disease”, this is a very pessimistic description. Multiple sclerosis is included in the group of chronic progressive diseases. But it is important to emphasize that today this disease is curable, that is, it is treatable, it can be effectively controlled, which allows patients to maintain an active life and work capacity for a long time. In this disease, early diagnosis is important, because we have the opportunity to minimize the progression of the disease and stabilize the patient at the stage at which we met with him, established the diagnosis and began treatment.

– Is multiple sclerosis considered a disease of the young? At what age does it most often appear?

О.А.: According to statistics, the onset of the disease occurs at the age of 16-35 years, rarely in childhood and over 50 years of age. On average, the disease most often manifests itself in 25-30 years. Therefore, multiple sclerosis is truly a “disease of the young.”

– What are the symptoms of this disease?

OA: The difficulty is that multiple sclerosis has no specific symptoms. Most often, visual disturbances occur (especially in one eye) at the onset of the disease; unsteadiness, weakness, and numbness may also appear. In the literature there are various popular names for multiple sclerosis – “monkey of all diseases”, “a disease with a thousand faces”. Therefore, the diagnosis of multiple sclerosis is a very complex and lengthy process; the diagnosis, like a puzzle, consists of many components. For diagnostics, all modern research methods are used, including MRI, laboratory and functional diagnostics.

– When you come to see you for the first time, does it mean that you continue to see patients for the rest of your life?

О.А.: Yes, as a rule, I see patients all the time from the moment they apply, in the process I get to know their families, I know the life situation of almost every of my regular patients. I also maintain a separate register of pregnant women – more than 50 young women with multiple sclerosis have already been able to endure and give birth to children.

– How difficult is it for people to accept their diagnosis?

О. А.: Of course, the psychological aspect is very important. It is often difficult for young people to accept their illness on a psychological level. They read information in open sources and until the last moment they are not ready to apply it to themselves. We try to convince of the importance of starting treatment at the initial stage in order to preserve the quality of life to which he is accustomed for as long as possible. However, we are not omnipotent, the type of course of the disease, which is genetically determined, is of great importance.

– If the disease cannot be completely cured, what can be considered a good result?

О.А.: We start treatment from the moment when the diagnosis is made, our main task is to stay at this level, if we manage to do this for many years, then this is a good result. In general, a stable state without clinical manifestations of the pathological process is the main goal we are striving for.

Multiple sclerosis average age: What Is the Age of Onset for Multiple Sclerosis?

What Is the Age of Onset for Multiple Sclerosis?

What Is the Average Age for a Multiple Sclerosis Diagnosis?

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