As people with multiple sclerosis (MS) live longer, healthcare providers face new challenges in treating elderly patients. The treatment of elderly individuals with MS is complicated by the effects of immunosenescence, the natural weakening of the immune system that comes with age. This makes standard disease-modifying therapies (DMTs) less effective and increases the risk of infections and side effects.
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Figure 1: Management of Multiple Sclerosis in elderly patients
Late-onset MS (LOMS), where MS develops after the age of 50, presents additional challenges, including faster disease progression and more severe disability. Research suggests that older adults with MS respond differently to therapies, and their treatment must be tailored to account for age-related changes in immune function. Moreover, older patients are often more susceptible to infections and cancers, which are exacerbated by DMTs that suppress the immune system.
One approach being explored is the de-escalation of treatment, where patients with stable disease transition from high-efficacy therapies to lower-risk treatments to reduce adverse effects. However, this strategy requires careful monitoring, as discontinuing aggressive treatment can lead to disease reactivation. Another approach involves focusing on symptom management and improving the quality of life rather than solely targeting disease progression.
Further research is needed to fully understand how to optimize MS treatment in older adults. Current strategies must balance the need for disease control with the heightened risks posed by aging, making it essential for healthcare providers to take a personalized approach to care in this growing population.
Summary by Faith Oluwamakinde
