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Multiple Sclerosis (MS) in the Elderly

Multiple Sclerosis (MS) in the ElderlyMultiple sclerosis (MS) is a nerve disease that reaches its peak in the senior years of life. It starts earlier in life, usually between the 20s and 40s, and gradually worsens. By the time a person with multiple sclerosis reaches the senior years the condition can reach a point where it causes irreversible muscle weakness or paralysis and other debilitating complications. This further complicates the age-related limitations of an older person and multiple sclerosis sufferers often need the help of caregivers in the senior years. Despite being incurable, it is important for younger multiple sclerosis patients to seek treatment so as to avoid these complications later in life even if the MS symptoms are mild.

Causes of Multiple Sclerosis

Nerves are covered with an insulating sheath known as the myelin sheath. It is necessary for nerves to function properly. In multiple sclerosis this myelin sheath is gradually damaged and destroyed and nerve activity is compromised. Therefore multiple sclerosis is known as a demyelinating disease. The exact cause of multiple sclerosis is unknown but it appears to be associated with an autoimmune mechanism. This means that the body’s immune system starts attacking the nerve sheath for unknown reasons.

There some factors which can increase the risk of developing multiple sclerosis. This includes :

  • Family history of multiple sclerosis.
  • Other autoimmune diseases like inflammatory bowel disease or autoimmune endocrine diseases (affecting glands).
  • Infections like Epstein-Barr virus (EBV) or infectious mononucleosis.
  • Caucasian women in the 20 to 40 age group appear to be the highest risk group for unknown reasons.

A person with one or more risk factors will not definitely develop multiple sclerosis. It only affects about 60 to 90 people out of 100,000.

Signs and Symptoms

In the early stages, there are episodes of acute symptoms (attacks) which then resolve either completely or partially for periods of time only to relapse again. Some people have very mild or almost no symptoms. However, over time the condition gradually worsens to the point where the signs and symptoms are permanent. The most debilitating symptoms are seen in the elderly.

  • Vision problems – blurring, double vision, loss of vision (partial or complete) which is usually one-sided.
  • Eye pain worse during eye movement.
  • Numbness, tingling or pain in the limbs.
  • Tremors.
  • Dizziness.
  • Lack of coordination.
  • Unsteady when walking or standing.
  • Fatigue.

As the disease progresses and worsens, several other signs and symptoms become evident which are complications of multiple sclerosis. This includes :

  • Paralysis usually of the bottom half of the body.
  • Muscle stiffness.
  • Difficulty with urinating or defecating.
  • Impairment of sexual functioning.
  • Poor memory.
  • Difficulty concentrating.
  • Depression.

Treatment

Medication is used to treat acute attacks, slow the progression of the disease and control the symptoms of multiple sclerosis or its complications. The drugs used for acute attacks, like corticosteroids, are intended to reduce immune functioning.but only for short periods of time.

Various drugs for slowing multiple sclerosis targets the immune system as well by preventing immune cells from attacking the nerve sheath, trapping cells within lymph nodes or impeding the movement of immune cells through the body. Immunosuppressant drugs are only sometimes used long term to slow the progression of multiple sclerosis.

Other drugs are used to treat and control symptoms like muscle stiffness, bowel and bladder functioning and depression. Physical therapy is ongoing for multiple sclerosis patients to treat muscle problems. Various exercises will also help ease muscle stiffness.


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