Late-Onset Multiple Sclerosis

Medically Reviewed by Jabeen Begum, MD on August 26, 2024
4 min read

When you have multiple sclerosis (MS), your immune system attacks nerve cells and fibers called axons in your brain. When this happens, your brain can’t send electrical messages to your body as well as it should. That changes the way your body moves and operates. Most people start to get MS symptoms between 20 and 40 years of age. But sometimes, you won’t have any MS symptoms until you’re 50 or older. When this happens, doctors call it late-onset multiple sclerosis (LOMS).

Symptoms of multiple sclerosis are generally the same, regardless of how old you are when it develops. The differences lie in which symptoms you're more likely to have and how quickly they get worse.

It can also be harder to identify late-onset MS because symptoms are often mistaken for signs of normal aging or other health conditions that are more common in older people such as stroke and Alzheimer's disease.

Symptoms typically include:

  • Fatigue
  • Muscle weakness
  • Changes in your vision
  • Decline in cognitive ability (memory trouble, having a hard time focusing)
  • Depression
  • Numbness and tingling
  • Pain
  • Dizziness
  • Squeezing sensation around your torso
  • Bladder and bowel problems
  • Tremors
  • Stiffness
  • Balance and coordination problems
  • Trouble walking
  • Sexual problems

With late-onset MS, the main symptoms are problems with walking and balance, unpleasant sensations such as a prickling or tingling feeling, vision problems, and cognitive decline. The disease also progresses faster.

There isn’t a single lab test doctors use to diagnose multiple sclerosis. Instead, they use several tests to check out your nervous system and brain. Some of the tests your doctor might use to diagnose late-onset multiple sclerosis include:

MRI of the brain and spinal cord. The MRI test can show any plaque or scars on your brain, which is a key indicator of MS.

Cerebrospinal fluid (CSF) evaluation. To do this test, your doctor will take a sample of the fluid that surrounds and protects your spine and brain. They’ll examine the amount of proteins and cells in the fluid for abnormalities or problems with your immune system.

Sensory evoked potential studies. Your doctor might test how your brain responds to sight, sound, and electrical stimuli to measure how electrical impulses travel in your brain and spinal cord.

But as you age, it can be harder to diagnose MS, so your doctor may study your neurological history as well to help confirm late-onset MS.

Multiple sclerosis is a difficult condition to predict. Sometimes, the condition progresses slowly, but at other times, it moves quickly. Late-onset MS shows similar nervous system changes as adult-onset MS. But when you develop the condition later in life, it may progress faster.

Research shows people with late-onset MS reach certain physical disability milestones, such as needing to use a cane or a wheelchair, two or three times as fast as people diagnosed earlier in life.

Older adults with MS also have a greater risk of the primary progressive form of the condition. This means that your body will likely gradually decline over time without any breaks from MS activity, so remission is unlikely.

There is no cure for any type of multiple sclerosis, but there are many ways for you to manage the condition. You may have limited options, though, compared to someone with adult-onset MS. Many of the drugs used to treat MS haven't been tested in people over 55. And potential side effects can be more serious for older people, especially if you have other health problems.

Some common treatments for late-onset multiple sclerosis include:

Medication. There are many types of medications to treat relapsing forms of MS. There is one medication, Ocrevus (ocrelizumab), that is approved to treat primary progressive multiple sclerosis. The good news is your doctor can give you treatments that help manage your symptoms.

Managing relapses. Corticosteroids (steroid hormones), adrenocorticotropic hormone (ACTH) in a gel, or a plasma exchange can help manage MS flare-ups.

Rehabilitation. Physical, occupational, and cognitive rehabilitation can help you manage the way MS changes your body. These programs can give you better mobility, limit fatigue, and improve your memory. If you have trouble speaking or swallowing, speech-language pathology can help.

Late-onset multiple sclerosis is a form of the disease in which symptoms develop after age 50. Common symptoms include trouble with balance and walking, plus thinking and memory problems. Late-onset MS tends to get worse more quickly than MS that's diagnosed in younger people. Your doctor can come up with a treatment plan to help manage your symptoms and improve your quality of life.