Multiple Sclerosis in Middle-Aged and Elderly Patients

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Abstract

Currently, the number of middle-aged and elderly patients with multiple sclerosis (MS) is increasing. The incidence of late-onset multiple sclerosis (LOMS), defined as disease onset after the age of 50, is also growing. Given that MS has always been considered a disease of young adults, its course and transformation in the context of aging, as well as its associations with aging processes, necessitate investigation. Diagnostic and treatment approaches require re-evaluation to find the most effective and safe options for elderly patients with MS. This article analyzes available data on the course, diagnosis, and treatment of MS in patients aged over 50. It has been shown that MS activity decreases with age, which can possibly be attributed to age-related changes in the immune system. At the same time, there is an increase in comorbidities associated with age and MS, as well as with a transition of the disease from an inflammatory to a neurodegenerative phenotype. The efficacy of pharmacologic interventions tend to decrease, or they become unsafe due to the risk of serious side effects. However, there is a growing body of evidence worldwide on the safety and efficacy of long-term use of disease-modifying drugs in elderly patients with MS.

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About the authors

Oscar V. Lutov

Bashkir State Medical University

Email: lyutov@yandex.ru
ORCID iD: 0000-0003-1393-1122
SPIN-code: 6435-3559

postgraduate student, Department of Neurology 

Russian Federation, 3 Lenina st, Ufa, 450008

Ulyana Sh. Kuzmina

Bashkir State Medical University

Email: ukuzmina87@gmail.com
ORCID iD: 0000-0001-7056-7895
SPIN-code: 8775-5065

Cand. Sci. (Biology), Assistant Professor, Department of Biological Chemistry

Russian Federation, 3 Lenina st, Ufa, 450008

Irina D. Talipova

Republican Clinical Hospital named after G.G. Kuvatov

Email: ira.talipova.2021@mail.ru
ORCID iD: 0009-0009-1064-6589
SPIN-code: 9299-2790

postgraduate student, Department of Neurology

Russian Federation, Ufa

Timur R. Galiullin

Bashkir State Medical University

Email: trgaliullin@mail.ru
ORCID iD: 0000-0002-4558-6119
SPIN-code: 8070-2217

MD, Cand. Sci. (Medicine), Assistant Lecturer, Department of Neurology 

Russian Federation, 3 Lenina st, Ufa, 450008

Mansur A. Kutlubaev

Bashkir State Medical University

Email: mkmed@mail.ru
ORCID iD: 0000-0003-1001-2024
SPIN-code: 4713-0312

D. Sci. (Med.), Associate Professor, Head of the Department of Neurology

Russian Federation, 3 Lenina st, Ufa, 450008

Klara Z Bakhtiyarova

Bashkir State Medical University

Author for correspondence.
Email: bsmu-neuro@yandex.ru
ORCID iD: 0000-0003-0982-4324
SPIN-code: 4129-2864

MD, Dr. Sci. (Med.), Professor, Professor, Department of Neurology

Russian Federation, 3 Lenina st, Ufa, 450008

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