Researching late-onset MS
MS is typically diagnosed when someone is in their 20s to 40s. But it can be diagnosed at any age. We caught up with Dr Sara Collorone, a researcher at University College London, to learn more about her MS Society-funded research.
Firstly, please could you tell us what late-onset MS is?
In the clinic, we tend to see people diagnosed with MS between the ages of 20 and 40. But this does vary. Some people are diagnosed at a younger age, while others might be diagnosed later in life. We classify anyone who experiences their first symptoms after the age of 50 as having late-onset MS.
Do you see differences in people who are diagnosed with late-onset MS, compared to those diagnosed earlier?
In general, it seems that people who are diagnosed with late-onset MS experience earlier progression of disability. These people tend to reach a higher EDSS (the scale used to measure disability) after fewer years.
But we don't know for sure if this is down to MS or because ageing itself has an impact. The brain may be less able to compensate for the changes associated with MS as we age. And people who are diagnosed later in life often have other health conditions, like high blood pressure. This might also be impacting the brain.
What is your research focusing on?
I want to understand more about the features of late-onset MS and the different factors contributing to disability progression. For example:
- how people's symptoms affect them
- what level of disability they experience
- the treatments they have access to
- the impact other health conditions might have
I'm using data from the UK MS Register and also looking at MRI scans.
How does data from the UK MS Register help your research?
The MS Register is an invaluable source of data. There's an online portal where people with MS can fill out surveys about their health, treatments and lifestyle. And this can be combined with clinical data added by clinicians. This gives us a really rich source of data about the population of people with MS in the UK. It can tell us about other health conditions people with MS have. And the treatments they take, and why people might change or stop treatments.
Late-onset MS is quite rare. So data from the Register can give us more information than if we were collecting data from just a single research centre. It can help us build up a better picture of this type of MS.
How could this research help people with late-onset MS?
Late-onset MS feels like a neglected area of research. So this is a step towards gathering more data about the condition. By doing more research with people with late-onset MS, we can raise awareness about it. And even go on to design more inclusive clinical trials. This could let us gather data about the safety of disease modifying therapies (DMTs) in older people. Because we know that many trials currently have an upper age limit and can exclude people who are over 60.
Ultimately, I hope this research makes an impact on the treatment choices available to people with late-onset MS.
The more effective DMTs can come with additional risks, like an increased rate of infections. And there are limits to the treatments that can be used in people with MS who have cancer – something we know is more common as people age. This can make it difficult for healthcare professionals and people with MS to weigh up the risks and benefits of taking a treatment. Knowing more about late-onset MS could help to tailor decisions about treatments to each person.
This blog came from an article in our MS Matters magazine.
