Highlights
- •Association between MS disability and onset age is different with symptom onset before and after an age range of 30–35 years.
- •Use of progression model to measure disability produced similar results to MSSS.
- •The progression model could be used as a replacement for the MSSS score if validated.
Abstract
Background
While many factors have been examined, male gender and older age at multiple sclerosis
onset are among few variables consistently associated with increased disability. Interestingly,
the association between onset age and disability may not be linear with some data
suggesting a faster rate of accumulation of disability in patients aged more than
30 years at onset.
Objective
Explore the relationship between onset age and disability.
Methods
We studied 500 MS patients grouped by cut-offs in onset age. Disability was assessed
using Multiple Sclerosis Severity Scale (MSSS) and, a model based on time to reach
an Extended Disability Severity Score (EDSS) (progression model). Data were analyzed
using linear and logistic regression.
Results
The association between disability (assessed by both MSSS and the progression model)
and onset age was different in patients whose MS onset occurred after an age band
of 30–35 years. Before this age range, changing age was not associated with changes
in disability while during and after this age range, disability was increased.
Conclusion
We found a significant change in the relationship between disability and onset age
after about 31 years supporting the idea that while onset age does not define a sharp
cut-off, it can help define subgroups of patients with differing rates of accumulation
of disability.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process.Brain. 2003; 126: 770-782
- Age at disability milestones in multiple sclerosis.Brain. 2006; 129: 595-605
- The clinical course of multiple sclerosis.Handb Clin Neurol. 2014; 122: 343-369
- On the risk of multiple sclerosis according to age at immigration to South Africa.Br Med J. 1971; 3: 725-759
- Searching for needles in haystacks – the genetics of multiple sclerosis and other common neurological diseases.Brain Res Bull. 2003; 61: 229-234
- A reassessment of the distribution of multiple sclerosis.Acta Neurol Scand. 1975; 51: 137-157
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; 33: 1444-1452
- Epstein–Barr virus: environmental trigger of multiple sclerosis?.Virology. 2007; 81: 6777-6784
- Diagnosis and treatment of multiple sclerosis.Br Med J. 2006; 332: 525-527
- Susceptibility and outcome in MS: associations with polymorphisms in pigmentation-related genes.Neurology. 2004; 62: 2323-2325
Pena JA, Lotze TE. Pediatric multiple sclerosis: current concepts and consensus definitions. Autoimmune Dis 2013. 10.1155/2013/673947.
- Progression of disability in multiple sclerosis: a study of factors influencing median time to reach an EDSS value.Mult Scler Relat Disord. 2012; 2: 109-116
- Multiple Sclerosis Severity Score: using disability and disease duration to rate disease severity.Neurology. 2005; 64: 1144-1151
- Multivariate analysis of predictive factors of MS with a validated method to assess clinical events.J Neurol Neurosurg Psychiatry. 1995; 58: 300-306
- The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability.Brain. 1989; 112: 133-146
- HLA-DRB1 and disease outcome in multiple sclerosis.J Neurol. 2001; 248: 304-310
- Occupational exposure to UV light and mortality from multiple sclerosis.Am J Ind Med. 2009; 52: 353-357
- Studies of associations between disability in multiple sclerosis, skin type, gender and ultraviolet radiation.Mult Scler. 2007; 13: 369-375
Article info
Publication history
Published online: June 23, 2014
Accepted:
June 17,
2014
Received in revised form:
May 14,
2014
Received:
November 5,
2013
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
