Age and disability accumulation in multiple sclerosis
Open accessAbstract
OBJECTIVES: We tested the hypothesis that age is a prognostic factor with respect to long-term accumulation of disability in multiple sclerosis (MS). METHODS: Kaplan-Meier analysis and binary logistic regression models determined the effect of age at disease onset, age at onset of progression, and current age on attainment of severe disability levels (Disability Status Scale [DSS] 6-8-10) from the London, Ontario, database (n = 1,023). RESULTS: Older age at relapsing-remitting (RR) phase onset was associated with higher risk of reaching advanced DSS 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 (odds ratio [OR] = 4.22) and at age 50 (OR = 6.04) 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 DSS scores from disease onset. The progressive course, unaffected by age at RR onset, was only modestly affected by age at SP onset. Among primary progressive and RR/SP patients, median ages at attainment of DSS scores were strikingly similar: DSS = 6, 49 vs 48 years; DSS = 8, 58 vs 58 years; and DSS = 10, 78 years for both (p = NS for all comparisons). CONCLUSIONS: Development of SP 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.
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Age is the strongest predictor for the transition from the relapsing phase of multiple sclerosis to the secondary progressive phase.
“Age is the strongest predictor for the transition from the relapsing phase of MS, which is primarily inflammatory to the secondary progressive phase of the disease, which is thought to be mainly neurodegenerative [10,11].”
From Ageing, Cellular Senescence and Neurodegenerative Disease (2018) · cites this paper as [11]
Epidemiological evidence suggests that age is the most important determinant for the transition to the progressive phase of MS.
“Epidemiological evidence suggests that age is the most important determinant for the transition to the progressive phase of MS [11].”
From Ageing, Cellular Senescence and Neurodegenerative Disease (2018) · cites this paper as [11]
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- Authors
- Scalfari, A., Neuhaus, A., Daumer, M., Ebers, G. C., & Muraro, P. A.
- Affiliations
- University of Oxford (GB)
- From the Centre for Neuroscience (A.S., P.A.M.), Division of Experimental Medicine, Imperial College London, UK; Sylvia Lawry Centre (A.N., M.D.), Munich, Germany; and Department of Neurology (G.C.E.), University of Oxford, Oxford, UK.
- Venue
- Neurology
- Published
- 2011-09-27
- Volume
- 77
- Issue
- 13
- Pages
- 1246-1252
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3179646
- OpenAlex
- W2013481339
- Cited by
- 279
- References
- 0
- Citations by year
- 2026: 16 · 2025: 21 · 2024: 27 · 2023: 21 · 2022: 16 · 2021: 29 · 2020: 27 · 2019: 23 · 2018: 14 · 2017: 19 · 2016: 18 · 2015: 12 · 2014: 10 · 2013: 16 · 2012: 9
- FWCI
- 8.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Sanofi
- Biogen
- Fondazione Italiana Sclerosi Multipla
- European Committee for Treatment and Research in Multiple Sclerosis
- UK Stem Cell Foundation
- Multiple Sclerosis Society of Canada
- Multiple Sclerosis Society
- University of Southampton
- Imperial College London
- University of Oxford
- Bundesministerium für Bildung und Forschung
- Universität Wien
- Medical Research Council (G0800679)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- multiple sclerosis, age of onset, disability progression, secondary progressive multiple sclerosis, relapsing-remitting multiple sclerosis, primary progressive multiple sclerosis, prognosis, age as prognostic factor
- MeSH terms
- Adolescent, Adult, Aging, Disability Evaluation, Female, Disabled Persons, Persons with Disabilities, Humans, Longitudinal Studies, Male, Multiple Sclerosis, Ontario, Predictive Value of Tests, Retrospective Studies, Logistic Models, Age of Onset, Disease Progression, Kaplan-Meier Estimate, Young Adult
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