Late-Onset Multiple Sclerosis

Medically Reviewed by Sabrina Felson, MD on August 21, 2022
3 min read

When you have multiple sclerosis, your immune system attacks nerve cells and fibers called axonsin 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 old. But sometimes, you won’t have any MS symptoms until you’re 50 or older. When this happens, doctors call it later-onset multiple sclerosis (LOMS).

Symptoms of late-onset multiple sclerosis are often mistaken for signs of normal aging. They typically include:

  • Fatigue
  • Muscle weakness
  • Changes in your vision
  • Decline in cognitive ability (memory trouble, having a hard time focusing)

Late-onset MS causes a lot of changes in your motor skills too. You might notice:

  • Bladder and bowel problems
  • Tremors
  • Stiffness
  • Balance and coordination problems
  • Trouble walking

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 magnetic resonance imaging 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 early onset MS. But when you develop the condition later in life, it may progress faster.

Older adults with MS have a greater risk of the primary progressive form of the condition as well. 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. 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, or 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.

Talk to your doctor if you’ve been diagnosed with late-onset multiple sclerosis. There are many ways they can help you manage symptoms and improve your quality of life.