Clinical and Epidemiological Aspects of Late Onset Multiple Sclerosis in East-Azerbaijan, Iran; A Population-Based Study.

BACKGROUND

Late-onset multiple sclerosis (LOMS) is defined as symptoms initiating at an age above 50.

OBJECTIVE

This study aims to determine the clinical and epidemiological aspects of LOMS in East-Azerbaijan province, Iran.

METHODS

This population-based study recruited nearly all MS patients to the end of 2020, who were diagnosed at age≥50, by referring to the only local MS registry center. We investigated prevalence, sex, age-of-onset, first clinical presentation, family history, and gap of diagnosis. Also, we compared the disease characteristics between male and female cases.

RESULTS

Out of 4905 total cases of MS, 217 cases (4.42%) were LOMS. The mean age of onset was 53.80±3.41 years with a maximum age of 68 years. The most common age group of the patients was 50 to 55 years (69.1%). The frequency by sex of LOMS in females (150) was greater than males (67). Positive family history was seen in 6.17%, and in 41% of the patients, the disease was diagnosed in a timely manner. Early symptoms were motor (31.3%), sensory (24.8%), optic neuritis (23%), cerebellar symptoms (13.8%), and brainstem symptoms (6.9%). The first presentation of the disease was different between male and female cases (-value<0.01). Motor symptoms were the most prevalent first clinical presentation in female cases (37.6%), while in male cases, cerebellar symptoms (25.8%) were the most common.

CONCLUSION

LOMS is not a rare condition. Increasing knowledge in the diagnosis, as well as increasing awareness of the disease in the general population, leads to early diagnosis of LOMS and prevention of consequences.