How Age Affects Multiple Sclerosis Symptoms and Progression?

Inflammation and demyelination characterize multiple sclerosis (MS). It is a chronic inflammatory illness of the central nervous system (CNS) that can cause irreversible neurologic impairment. It is the leading cause of adult neurologic impairment not caused by trauma. Because its average onset is between the ages of 20 and 40, multiple sclerosis has traditionally been seen as a disease of the young. Nonetheless, people are living longer than ever before. The average age of people with MS has also increased due to medical progress in the field.

As a result, multiple sclerosis can no longer be considered a disease of young adults, as patients will continue to be seen by specialists far into old age. There are many unknowns about multiple sclerosis (MS), including its phenotypes, disease history, related comorbidities, immune system aging (immunosenescence), magnetic resonance imaging (MRI) characteristics, sensitivity to disease-modifying treatments (DMTs), and disease progression.

In this article, we will discuss the effects of age on MS symptoms and development.

MS and age of onset

Although MS can arise at any age, doctors typically diagnose it in persons in their twenties and thirties.

Myelin, which normally insulates nerve fibers, is compromised in MS. This injury prevents the normal transmission of signals between the brain and the rest of the body. The severity of your symptoms will increase proportion to the extent of myelin damage.

The symptoms of multiple sclerosis might manifest differently in each individual. Your disease's progression and the symptoms you experience may differ from those of others with the same disease.

The first attack

A single attack is generally the first symptom of MS. Your legs go numb or weak, or your vision blurs suddenly. The clinically isolated syndrome is the term used to describe when these symptoms have occurred for the first time and have lasted for at least 24 hours (CIS).

The average onset age for CIS is between 20 and 40. Inflammation or injury to myelin in the central nervous system is the root reason. However, not all cases of CIS are precursors to MS.

The likelihood of developing multiple sclerosis increases if an MRI reveals lesions in the brain.

Multiple Sclerosis with Relapses and Remissions (RRMS)

Relapsing-remitting multiple sclerosis is the initial diagnosis for up to 85% of MS patients (RRMS). It usually begins in one's twenties or thirties but can occur at any age.

Relapses are times of increased symptom severity experienced by people with RRMS, caused by attacks on myelin. Symptoms that may occur during a relapse are −

  • Numbness or tingling

  • Weakness

  • Vision loss

  • Double vision

  • Fatigue

  • Problems with balance

There is a wide range in how long each relapse lasts. Each individual may experience a unique combination of symptoms, some milder than others.

Remission is the time after a relapse during which you experience no symptoms. Each remission phase can last for months or even years. There are no new symptoms and no worsening of existing ones during remissions, except recurrences of symptoms due to infections, exhaustion, or overheating.

While you may not experience any worsening of symptoms during remission, an MRI may nonetheless show the progression of the disease.

Several persons with RRMS have lived there for decades. In a matter of years, others make the transition to the secondary progressive type. Although the course of multiple sclerosis can't be predicted for any one patient, recent advances in treatment have helped to limit the disease's advancement.

First-stage progressive MS (PPMS)

The primary progressive form of multiple sclerosis affects about 15 percent of MS patients (PPMS). Mid- to late-30s is a common time for PPMS onset.

The damage to the neurological system and the symptoms of PPMS worsen over time. There are no true periods of remission. The illness worsens with time, and walking or carrying out other routine tasks may become difficult.

Secondary progressive MS (SPMS)

SPMS is the next stage of progression after RRMS. Myelin damage worsens with time in this kind of multiple sclerosis. Long remissions are not as likely as they were with RRMS. If the damage to the nerve system continues to worsen, so will the symptoms.

Historically, 50% of those diagnosed with RRMS progressed to SPMS after 10 years, and 90% did so within 25 years.

New MS medications are potentially slowing the rate at which certain patients develop to SPMS and may perhaps slow the rate at which some patients progress to SPMS altogether. It is too soon to tell if the new MS medications would slow the onset of SPMS.


Multiple sclerosis (MS) is a chronic condition that often manifests in childhood. The initial manifestation is typically the relapsing-remitting type, in which patients experience relapses and periods without symptoms.

The secondary progressive stage of the disease is inevitable if therapy is not provided. Yet, improved therapies are halting the progression of MS, sometimes for decades.

Someswar Pal
Someswar Pal

Studying Mtech/ AI- ML

Updated on: 24-Apr-2023


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