The Changing Face of Multiple Sclerosis: Addressing the Demographic Shift Towards Elderly Patients

Author(s)/Faculty: Patricia K. Coyle, MD, FAAN, FANA; Anne H. Cross, MD; Patricia Melville, MSN, NP-C, MSCN; Bianca Weinstock-Guttman, MD
Release Date: 7/18/2022Expiration Date: 7/17/2023
Credit Type: CME / CPE / CNENumber of Credits: 0.75
Content Type: LectureProvider:
For a variety of reasons, people with multiple sclerosis (MS) are living longer. The increasing prevalence of MS in the older population is intimately tied to the weakening of both the innate and adaptive components of the immune system over time. This phenomenon, referred to as "immunosenescence," is linked to another natural aging process—chronic low-grade inflammation, or “inflamm-aging.” Collectively, these processes create an environment conducive to ongoing neurodegeneration and disease progression in older patients with MS. Disease-modifying therapies (DMTs) are the standard of care treatment for MS; however, their safety and efficacy in older adult patients remain largely unknown, due to the lack of older patients enrolled in pivotal clinical trials. In the absence of evidence-based guidance, the use of DMTs in older adult patients with MS remains controversial. It is also unclear whether DMTs can be discontinued safely in older patients with stable disease. Additionally, the advanced age of these patients makes them as, if not more, vulnerable to age-related comorbidities, which also must be factored into management strategies for their overall care. In this CE activity, The Changing Face of Multiple Sclerosis: Addressing the Demographic Shift Towards Elderly Patients, experts in the field present didactic information and cases to summarize evidence-based, individualized approaches to treating older adult patients with MS, including the risks and benefits of using DMTs as well as the contributions of aging, age-related immune changes, and immunosenescence in the pathophysiology of MS in older adults.