Thursday, 3 November 2016

Older people accumulate deficit quicker

Alroughani R, Akhtar S, Ahmed S, Behbehani R, Al-Hashel J.Is Time to Reach EDSS 6.0 Faster in Patients with Late-Onset versus Young-Onset Multiple Sclerosis?PLoS One. 2016 Nov 1;11(11):e0165846. doi: 10.1371/journal.pone.0165846.

BACKGROUND & OBJECTIVES:
Published natural history data on late-onset of multiple sclerosis are limited. We aimed to assess the risk of attaining EDSS 6.0 among patients with late-onset (> 40 years) MS (LOMS) and young-onset (18-40 years) MS (YOMS).
METHODS:This cross-sectional cohort study was conducted to identify LOMS and YOMS patients' with relapsing remitting course at MS diagnosis. Time (years) to reach sustained EDSS 6.0 was compared between LOMS and AOMS patients. Cox proportional hazards model was used to evaluate the demographic and clinical predictors of time to EDSS 6.0 in these cohorts.
RESULTS: LOMS and YOMS cohorts comprised 99 (10.7%) and 804 (89.3%) patients respectively. Spinal cord presentation at MS onset was more common among LOMS patients (46.5% vs. 32.3%). The proportions of LOMS and YOMS patients reaching EDSS 6.0 during the follow-up period were 19.2% and 15.7% respectively. Older age at MS onset (adjusted hazard ratio (aHR) = 3.96; 95% CI: 2.14-7.32; p < 0.001), male gender (aHR = 1.85; 95% CI: 1.22-2.81; p = 0.004) and spinal cord presentation at onset (aHR = 1.47; 95% CI: 0.98-2.21; p = 0.062) were significantly associated with shorter time to EDSS 6.0.
CONCLUSIONS:LOMS patients attained EDSS 6.0 in a significantly shorter period that was influenced by male gender and spinal cord presentation at MS onset.

Younger people have better compensatory capacity and accumulate damage slower than older pwMS

2 comments:

  1. I was diagnosed with progressive MS when I was 54 & I went from EDSS 3.5 (self assessment)to 6.5 I(neurologist assessment) in about 2 weeks when I was 55 following appendicitis and peritonitis (the link is my contention but supported by my neurologist). I am struggling find research that would give me any idea as to whether this is a particularly fast progression and also any research into the link between perionitis (or other infection) and progression. Any ideas where I should look?

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    1. Sounds like a relapse with maybe spinal lesion or lesions not seen on brain MRI that has caused irreversible damage. In other people such relapses recover.Progressive disease is a slower process not a catastrophic event. Obviously I am not a neurologist so maybe wrong.

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