Freeman Leorah, Lucas Ashlea, Zhou Jia, Hayward Brooke, Gough Mallory, Livingston Terrie
Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA (LF, AL).
EMD Serono, Rockland, MA, USA (JZ, BH, TL).
Int J MS Care. 2023 Mar-Apr;25(2):56-62. doi: 10.7224/1537-2073.2021-124. Epub 2022 Sep 13.
Multiple sclerosis (MS) typically presents in young adulthood. Recent data show the highest prevalence of MS in people aged 55 to 64 years; however, there are limited studies of this population.
Administrative US claims data from IBM-Truven MarketScan commercial and Medicare databases (2011-2017) were analyzed. People with MS 50 years or older were assigned to the aging MS cohort (n = 10,746). The matched controls were people 50 years or older without MS (n = 10,746). Multivariable models compared outcomes between groups.
Infections were more frequent in the aging MS cohort vs matched controls (61% vs 45%; < .0001); urinary tract, acute upper respiratory tract, and herpes zoster were the most frequent infection types. Malignancy rates were 20% for both groups ( = .8167); skin, breast, and prostate malignancies were the most frequent types. Skilled nursing facilities (aging MS cohort, 12%; matched controls, 3%; < .0001) and MRI (aging MS cohort, 87%; matched controls, 37%; < .0001) were used more frequently in the aging MS cohort; brain and spine were the most frequent types of MRI in the aging MS cohort. Time to first cane/walker or wheelchair use was shorter in the aging MS cohort (cane/walker use: HR, 2.1; 95% CI, 1.9-2.3; < .0001; wheelchair use: HR, 6.9; 95% CI, 6.0-8.1; < .0001).
In people 50 years or older, measures typically associated with worse health primarily resulted from having MS rather than being a consequence of aging alone.
多发性硬化症（MS）通常在成年早期发病。近期数据显示，55至64岁人群中MS的患病率最高；然而，针对该人群的研究有限。
分析了来自IBM - Truven MarketScan商业和医疗保险数据库（2011 - 2017年）的美国行政索赔数据。50岁及以上的MS患者被纳入老年MS队列（n = 10,746）。匹配的对照组为50岁及以上无MS的人群（n = 10,746）。多变量模型比较了两组之间的结果。
老年MS队列中的感染发生率高于匹配的对照组（61%对45%；P <.0001）；尿路感染、急性上呼吸道感染和带状疱疹是最常见的感染类型。两组的恶性肿瘤发生率均为20%（P =.8167）；皮肤、乳腺和前列腺恶性肿瘤是最常见的类型。老年MS队列中更频繁使用专业护理机构（老年MS队列，12%；匹配对照组，3%；P <.0001）和MRI（老年MS队列，87%；匹配对照组，37%；P <.0001）；脑部和脊柱是老年MS队列中最常见的MRI检查部位。老年MS队列中首次使用手杖/助行器或轮椅的时间更短（使用手杖/助行器：HR，2.1；95%CI，1.9 - 2.3；P <.0001；使用轮椅：HR，6.9；95%CI，6.0 - 8.1；P <.0001）。
在50岁及以上人群中，通常与健康状况较差相关的指标主要是由患有MS导致的，而非仅仅是衰老的结果。
