Epub ahead of print: Scalfari et al. Age and disability accumulation in multiple sclerosis. Neurology. 2011 Sep 14.
Objectives: This study tested the hypothesis that age is a prognostic factor with respect to long-term accumulation of disability in MS.
- Older age at relapsing-remitting (RR) phase onset was associated with higher risk of reaching advanced disability scores. This was independent of disease duration and early relapse frequency but secondary to increased risk of conversion to secondary progressive (SP) MS.
- Onset at age 40 and at age 50 doubled and tripled risks of developing SP, compared to age 20 (OR = 2.05).
- Younger age at conversion to SPMS was associated with shorter times to high disability scores from disease onset.
- Among MS’ers with primary progressive and relapse onset disease, median ages at attainment of disability scores were strikingly similar: walking stick, 49 vs 48 years; bed-bound 58 vs 58 years; and death, 78 years for both.
Conclusions: Development of SPMS is the dominant determinant of long-term prognosis, independent of disease duration and early relapse frequency. Age independently affects disability development primarily by changing probability and latency of SP onset, with little effect on the progressive course.
“This data suggests that your prognosis is affected by age, but the age at which you reach a specific disability is on average the same. This means that if you develop MS when you are older your disease progresses more quickly.”
“Please note these data refer to average effects across populations of MS’ers and cannot necessarily be used to predict what will happen in individual MS’ers.”