New care guidelines for seniors with MS

It is rare, but not unknown, for older people to develop Multiple Sclerosis (MS), an autoimmune disorder that affects the central nervous system. 

But that doesn’t mean people who developed the disease in their 20-40s, which is the most common age span, don’t live to their senior years. And they have health and medical needs that medical experts now believe current treatments and care plans are neglecting. 

Global experts, including several from Monash University in Melbourne, have developed guidelines to better manage MS in people over 50. 

Associate Professor Anneke van der Walt, a Monash neurologist, says the experts’ statement highlights an urgent need to transform the way MS is managed in seniors. 

“It brings together global experts to address what is fast becoming one of the most pressing challenges in MS care: ageing,” she said. 

Advancements in treatment and healthcare mean people with MS are living longer. 

More than half of the global MS population is 50 or older yet clinical trials, treatment guidelines, and diagnostic tools have not kept pace with this demographic shift. 

“We are still managing MS in older adults using tools and approaches designed for younger people. This creates blind spots in diagnosis, under-treatment, and missed opportunities to improve quality of life,” Dr van der Walt said.

Medical staff are having to manage the disease in older people, including dealing with additional complexity and the way ageing changes the disease itself.

The consensus statement recommends: 

• Better diagnostic frameworks to distinguish MS from common age-related conditions 
• New tools to monitor disease activity and progression that account for biological ageing and comorbidities 
• Tailored treatment strategies, including guidance on when and how to safely de-escalate or discontinue therapy 
• Inclusion of older people in clinical trials, overcoming a long-standing barrier to evidence-based care 
• Integration of holistic, multidisciplinary care including exercise, mental health support, and management of cardiovascular risk factors. 

The statement urges funders and regulators to prioritise research that includes older adults with MS, especially those with comorbidities who are typically excluded from clinical trials. 

It also emphasises the need to include consultation with those living with MS, calling for better access to information, tailored education, and a stronger role in guiding their care decisions as they age. 

Related reading: Monash, HealthDirect