Aging with multiple sclerosis – patients older than 55 years, their therapy history and comorbidities

Introduction: Patients older than 55 years with multiple sclerosis (MS) were not included in pivotal clinical trials and researchers have increased interest in this age group last years, to assess the safety and cost-effectiveness of using disease-modifying therapies (DMT). This population may suffers from more comorbidities than younger patients, which can lead to more disabilities and health complications. Objective: To describe clinical variables, DMT use and comorbidities in elderly patients with MS in a Brazilian referral center. Methods: We conducted a retrospective observational study based on medical records. 95 patients older than 55 years were included and we compared comorbidity frequency to a published systematic review that included 249 articles. Results: The mean and SD for age was 62.1 (5.1) years, and majority were women (n=75, 78.9%). RRMS (n=62, 65.3%) and SPMS (n=25, 26.3%) were the most frequent phenotypes, with EDSS scoring 3.5 (2.3) and 6.8 (0.9) points, respectively. The mean and SD for age at disease onset was 39 (10.5) years and for disease duration was 23.4 (10.4) years. Thirty-eight (40%) were without current DMT and 16 (17%) were currently on natalizumab. It has been used at least once by 35 (37%) patients of cohort – 14 (56%) of them are now SPMS patients. Fifty-three (56%) had a history of two or more DMT use. Eighteen (19%) patients used immunosuppressive therapies. The most prevalent comorbidity were psychiatric disorders (n=50, 52.6%), followed by hypertension (n=39, 41.1%), dyslipidemia (n=25, 26.3%) and thyroid dysfunction (n=20, 21.1%). Conclusion: This study provides descriptive data from older MS patients in a single center and may help explain the reality of aging patients with MS in Brazil or countries under development.