Postmortem Study of Late-Onset Multiple Sclerosis

Late-onset multiple sclerosis (LOMS) — i.e., onset after age 50 years — is associated with greater disability and shorter times to progression than younger-onset MS (NEJM JW Neurol Oct 26 2020 and Brain 2020; 143:3013). For this study, investigators used the U.K. MS Register database and the U.K. MS Tissue Bank to retrospectively review patients with LOMS and those with adult-onset (AO) MS and onset between ages 18 and 40 years.

Consistent with prior studies and compared with the AOMS cohort, more LOMS patients were male, had primary-progressive disease, and had gait-related symptoms. Patients with LOMS were treated earlier (0.7 years vs. 2.1 years) but less likely to be on high-efficacy therapy (15% vs. 29%). Postmortem histopathology from …