Multiple sclerosis (MS) is a chronic inflammatory disease that affects the central nervous system, including the brain, spinal cord, and optic nerves. It is caused by damage to the myelin sheath that surrounds and protects nerve fibers. This damage slows or blocks messages between the brain and body, leading to various symptoms. MS is usually diagnosed between the ages of 20 and 40, but it can occur at any age.
What Are the Early Symptoms of MS?
Some of the early symptoms of MS include:
– Vision problems – Blurred or double vision, eye pain, loss of color vision
– Numbness and tingling – Often affects the limbs, face, or trunk
– Weakness – Usually in the legs at first, affecting balance and coordination
– Fatigue – Feeling abnormally tired, lacking energy
– Dizziness – Lightheadedness, vertigo
– Cognitive changes – Issues with memory, concentration, attention, word finding
These early symptoms may come and go unpredictably, lasting for days to months at a time. Periods of remission with no symptoms can also occur. Over time, symptoms tend to become progressively worse.
What Causes MS?
The exact cause of MS is still unknown, but it likely involves a combination of genetic and environmental factors such as:
– Genetics – MS is not directly inherited, but having a close family member with MS increases your risk
– Vitamin D deficiency – Lower vitamin D levels are associated with higher risk
– Viral infections – Epstein-Barr virus may play a role in development of MS
– Smoking – Smokers have a higher risk of developing MS
– Gender – MS is over 3 times more common in women than men
– Age – Onset is usually between age 20 to 40
– Geography – MS is more common in certain geographical regions farther from the equator
What Age Does MS Usually Start?
The most common age for MS diagnosis is between 20 and 40 years old. About two thirds of people with MS have their first symptoms and are diagnosed sometime within this 20 year span:
– 10-20% experience first symptoms before age 18 (pediatric MS)
– 50% have onset between age 20 and 30
– 20-30% between age 30 and 40
– 5-10% after age 40 (late-onset MS)
The median age at diagnosis is about 30 years old. MS can technically start at any age, but getting it before age 10 or after age 60 is quite rare.
An estimated 8,000 to 10,000 children and adolescents in the US have MS. The average age of onset for pediatric MS is around 14 years old. Girls tend to develop it slightly earlier than boys.
Symptoms in children and teens are similar to adults. Fatigue, numbness, tingling, weakness, and optic neuritis are most common. Pediatric MS progresses slower than adult-onset MS on average.
MS in Young Adults
Young adulthood from the late teens through thirties is the most common period for MS to begin. Onset typically peaks between age 20 to 30.
Women are diagnosed more frequently than men starting in the early twenties, at a ratio of about 2 to 1.
Symptoms often start mildly but accumulate over time. MS is sometimes not recognized right away in young people, delaying diagnosis.
MS in Middle Age
Between ages 30 to 40, MS rates begin to decline but many still experience first symptoms during this time.
Around 20-30% receive an initial diagnosis in their thirties. Men start to catch up to women in rates of MS diagnosis in middle age.
Symptoms may be more significant by this point if the disease started earlier. Relapsing-remitting MS often transitions to secondary-progressive MS in one’s thirties.
Late Onset MS
About 5-10% of people with MS have onset of symptoms after age 40. This is considered late-onset or late-onset MS.
Average age of onset for late-onset MS is around 47 years old. It is defined as first symptoms starting after age 50 by some sources.
Late-onset MS is more likely to be primary progressive from the beginning rather than starting with relapses and remissions. It tends to involve more motor symptoms and disabilities.
Does Age at Onset Affect Prognosis?
Some research suggests that younger age of MS onset is linked with a better long-term prognosis:
– Pediatric onset MS has slower progression on average compared to adult-onset MS.
– Young adults who develop MS may have longer time periods between relapses and less residual symptoms during remissions early on.
– MS that starts after age 40 tends to involve faster progression of disability over time.
However, this association is not always consistent across studies. The influence of age at onset on long-term MS progression remains unclear.
Factors Affecting Progression
Other factors besides age impact how MS will progress over time, including:
– Sex – Women generally have less severe disability progression than men.
– Frequency of relapses – More relapses early on are linked to faster progression later.
– Degree of recovery – Incomplete recovery from attacks predicts worse outcomes.
– Type of MS – Primary progressive MS has faster progression than relapsing-remitting.
So age at onset is just one piece of the puzzle. Overall MS prognosis depends on many individual characteristics.
Does Family History Influence When MS Starts?
Having a first-degree relative with MS raises your risk of developing the condition. But family history does not seem to impact the specific age when symptoms first appear.
A study that looked at over 13,000 MS patients found no link between family history and age of disease onset. Having an affected sibling or parent did not raise the chances of early-onset or late-onset MS.
Ethnic background did influence age of onset in this study however. On average, Hispanics developed symptoms 7 years earlier than whites.
More research is still needed on how genetics interact with other MS risk factors throughout one’s life.
Can You Get MS After Age 60?
It is rare, but MS can sometimes begin after age 60. About 1% of people have their first attack of MS symptoms after age 60.
When MS starts later in life, it is referred to as very late-onset MS. It involves similar symptoms as MS with younger onset.
Some key features of very late-onset MS:
– Average age of onset is around 64 years old
– Often follows a progressive course rather than relapsing-remitting
– May have faster progression of disability
– More common in men
– Risk factors less clear
MS onset over age 60 likely has different underlying causes than MS starting at younger ages. More research is needed on very late-onset MS and how it compares to earlier-onset forms.
How Does Menopause Affect MS?
For women with MS, reaching menopause typically has beneficial effects:
– **Rate of Relapses** – Many women find their MS relapses decrease significantly after menopause. Declining estrogen is thought to play a role.
– **New Symptoms** – New neurological symptoms become less common for postmenopausal women with MS.
– **Progression** – Disability progression often slows after menopause compared to before.
However, some women may continue to have relapses and new symptoms after menopause. And a few experience worsening of their MS. It varies individually.
In summary, menopause often stabilizes MS disease course. But it does not mean all disease activity stops. Most women do gain some improvements after menopause.
MS Relapses During Perimenopause
In the transition to menopause called perimenopause, women may experience temporary worsening of MS relapses and symptoms.
Perimenopause describes the time leading up to menopause when estrogen levels become irregular but periods are not fully stopped. It typically lasts several years.
The fluctuating hormones during this stage can trigger increases in MS inflammation and new attacks for some women. These exacerbations are usually temporary though.
MS Progression After Menopause
A long-term study following women with MS found that:
– Only 11% had any sustained disease progression in the first 10 years after menopause
– Only 25% showed progression in the 20 years after menopause
So most women’s physical disabilities remain stable or improve after menopause, rather than worsening. However, cognitive symptoms may still accumulate in some women after menopause, since MS brain damage is irreversible.
Does Menopause Age Affect MS?
Research shows the age when a woman reaches menopause does not impact MS.
In a study of over 900 women with MS:
– Age of menopause onset had no association with age of MS onset.
– Reaching menopause earlier did not increase MS activity or progression.
– Later menopause also did not influence the MS disease course.
Overall, menopause timing in one’s 40s, 50s, or beyond did not affect MS relapses or progression of disability. The process of menopause itself appears most important.
Can You Develop MS in Your 60s?
It is rare, but a small percentage of people are diagnosed with MS for the first time in their 60s. About 2-5% of MS cases have onset of symptoms between ages 60 and 69.
MS beginning in the 60s is sometimes labeled late-onset MS. Key points about late-onset MS:
– Typical age of first symptoms is mid 60s
– Often follows primary progressive course rather than relapsing
– Usually progresses faster than younger-onset MS
– MS lesions in the brain tend to be located in different areas
– Men and women affected equally (unlike earlier onset)
– Less correlation with genetics and environmental risk factors
MS onset in the 60s likely has some distinct underlying disease mechanisms compared to earlier-onset MS. The causes of late-onset MS after age 60 are still being investigated.
Does MS Reduce Life Expectancy?
Several decades ago, MS was associated with substantially reduced life expectancy. However, prognosis has improved significantly with newer treatments.
Current estimates suggest:
– Average life expectancy is 5 to 10 years less for people with MS compared to the general population.
– Reduction in life span is most pronounced for those with MS onset before age 20.
– MS onset after age 50 may not reduce life expectancy at all.
With proactive care and disease-modifying therapy, many patients now have close to a normal lifespan. Severity of MS symptoms and disabilities is the most important factor determining longevity.
In summary, key points about when MS starts include:
– Onset is typically between ages 20 to 40, with average age around 30.
– About 10% have pediatric MS with first symptoms before age 18.
– 5-10% have later onset MS with first symptoms after age 40.
– Family history does not seem to affect age of onset.
– Menopause often improves MS relapse rate and progression.
– Very late MS onset after age 60 is uncommon but can occur.
– Life expectancy with MS is now close to normal in many cases with proper treatment.
MS most frequently starts in young adulthood, but can begin at any age from childhood to late life. Age of onset affects characteristics of the disease course and long-term outcomes to some degree.
Understanding typical ages of MS onset and diagnosis can help patients and doctors recognize symptoms sooner. Early treatment is key to preventing permanent damage and disability.
With expanding treatment options and better care, the MS prognosis continues to improve over time. Many patients now live close to full lifespans by managing their condition proactively.