More than half of people with MS are over the age of 50. In this group, slow progression is common, even in patients who respond well to treatment and therefore no longer experience new inflammations. In addition, older individuals who are newly diagnosed with MS are also more likely to have a progressive form of the disease from the very beginning. While younger patients can also experience this progressive form of MS, it is much less frequent at earlier ages.
Young and old
Treating ‘smoldering MS’ is challenging. Firstly, it can be difficult to distinguish between MS symptoms and normal signs of aging. Additional tests, such as spinal cord MRI and cerebrospinal fluid analysis, are often required. Secondly, treatment decisions are more difficult because of the increased risks and reduced effectiveness of therapies in older people. For younger patients, a slow but steady decline may lead to severe disability and high care needs at an early age, underscoring the importance of timely diagnosis and specialized treatment.
Multidisciplinary approach
The new consultation hour offers tailored care for people of all ages with MS who experience gradual disease progression. Patients from all over the Netherlands can be referred for a comprehensive evaluation and individualized treatment plan. The clinic emphasizes a multidisciplinary approach that balances safety, quality of life, and appropriate therapeutic strategies.
Recommendations
This new consultation hour at Amsterdam UMC follows the recommendations of the international working group Ageing in MS, in which radiologist Frederik Barkhof played an important role. These recommendations focus on better diagnostics to distinguish MS from age-related diseases, on the development of better biomarkers and measuring instruments that take age into account, and on adapted treatment strategies for people with MS. In addition, the importance of multidisciplinary care and regular evaluation of treatment choices is emphasized to optimize care for people with a progressive form of MS.
Future-oriented care for MS patients
With this new consultation hour, Amsterdam UMC aims to improve care and quality of life for people with a progressive form of MS. “Care for people with MS becomes increasingly complex as the disease progresses and patients age. With this initiative, we want to ensure that all patients with smoldering MS, both young and old, receive the specialized care they need, ” says neurologist Eva Strijbis.
Read the article in Nature Reviews Neurology: Advancing multiple sclerosis management in older adults
Source: MS Center Amsterdam