Monash University academics are among the global experts who have developed new guidelines to better manage multiple sclerosis (MS) in people over 50.
A consensus statement has been published in Nature Reviews Neurology that identifies gaps and creates a roadmap for future care of older people with MS.
Key recommendations include:
- 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 voices of those living with MS and encourages including them in care decisions.
What do the authors say?
The consensus statement was produced by an expert panel co-convened by the International Advisory Committee on Clinical Trials in MS and The European Committee for Treatment and Research in MS.
First author Associate Professor Anneke van der Walt, who leads the Monash University School of Translational Medicine MS and Neuro-ophthalmology Research Group and its Director, MS and Neuroimmunology Service at Alfred Health, said the statement highlighted an urgent need to transform the way MS was managed in people aged over 50.
“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 that people with MS are now living longer. More than half of the global MS population is aged 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.”