Clinical Features of Late-Onset Multiple Sclerosis: a Systematic Review and Meta-analysis

Abstract

Late-onset multiple sclerosis (LOMS) is defined as symptoms initiating after the age of 50. Misdiagnosis and a remarkable gap in diagnosis of LOMS is a challenge of the elderly population so in this article we described the proportion of LOMS and the clinical features and phenotype of the disease in this age group. Methods: After registration of the study protocol, an electronic search was performed in 3 databases and for full coverage of the published studies, we also checked the references of each related article. Articles with quantitative data were included in meta-analysis Results: 31 studies met our inclusion criteria for the systematic review, and 11 of them were included in the quantitative synthesis. Meta-analysis reached a 5.01% (95% CI: 3.78% to 6.57%), proportion of LOMS in total MS cases and prevalence was higher in women (64.46%). The most prevalent first disease presentation of LOMS was motor dysfunction (ranges between 100% to 35.4%) followed by sensory problems (ranges between 94% to 5%), visual symptoms (ranges between 22.9% to 5%), and brainstem dysfunction (ranges between 25% to 12.3%). 2.2% - 12.5% of the LOMS cases had a positive family history.