Late onset MS (LOMS)
LOMS, commonly defined as the occurrence of the first MS symptoms after the age of 50 years, accounts for approximately 3-5% of all MS diagnoses,  if not more [1-3]. The management of LOMS patients remains challenging. Not only may MS diagnostic criteria not be applicable to these patients, MS therapies have also been little studied in those aged 50 years and above, and age-related co-morbidities may be present . In clinical practice, these challenges seem to manifest in a delay in diagnosis  or, as recent data from the Italian MS registry suggest, a certain reluctance to treat LOMS patients [4,5], see figure. Importantly, patients who did receive treatment in the Italian LOMS cohort (most were on a 1st line MS agent) fared better over the long-term than those not receiving any MS therapy [4,5].
Proportion of never treated patients stratified by onset of MS (Data from an observational cohort study from Italy) 
- Vaughn CB et al. Nat Rev Neurol 2019; 15(6): 329-42. Return to content
- Smith Simonsen et al. J Neurol 2021; 268(4): 1330-41. Return to content
- Koch-Henriksen N et al. Neurology 2018; 90(22): e1954-63. Return to content
- Amato MP et al. Brain 2020; 143(10): 3013-24. Return to content
- Gaudioso C, Naismith RT. Brain 2020; 143(10): 2866-8. Return to content