Impact of age at onset on relapse-associated and relapse-independent disability accrual trajectories in…

Cohort studyMultiple sclerosis and related disorders· Aug 2026

Impact of age at onset on relapse-associated and relapse-independent disability accrual trajectories in multiple sclerosis.

Noemi Montobbio, Cinzia Cordioli, Ruggero Capra, Maria Pia Sormani

Multiple Sclerosis & NeuroimmunologyCohort studyPrognosisQ2IF 2.8

Each decade older at onset adds disability via relapse-independent progression, not relapses

Impact of age at onset on relapse-associated and relapse-independent disability accrual trajectories in multiple sclerosis.

Noemi Montobbio … Maria Pia Sormani

Multiple sclerosis and related disorders · Aug 2026 · Q2 in Neurology

Purpose

In multiple sclerosis (multiple sclerosis), older age at onset is linked to faster disability worsening and to increased frequency of progression independent of relapse activity (progression independent of relapse activity).

Methods

We analysed the long-term course of Expanded Disability Status Scale (Expanded Disability Status Scale) in patients with relapsing-onset multiple sclerosis followed at the Centre of Montichiari (Italy) between 1980 and 2022.

n = 1488 patients

Results

each decade later at onset means more disability from progression alone, not relapses

EDSS points/decade (PI 0.31 (95% CI 0.22 to 0.39)

CI excludes the null - significant

More results

Older age at onset was associated with a faster rate of Expanded Disability Status Scale worsening (p<0.0001).

This acceleration was driven by an increased contribution of progression independent of relapse activity (p<0.0001), while the rate of relapse-associated Expanded Disability Status Scale change remained stable throughout the whole onset age range (p=0.2251).

“

Conclusion

Increasing age at onset selectively amplified the rate of relapse-independent disability accrual, while relapse-associated worsening remained stable across onset ages.

Impact of age at onset on relapse-associated and relapse-independent disability accrual trajectories in multiple sclerosis.

Impact of age at onset on relapse-associated and relapse-independent disability accrual trajectories in multiple sclerosis.

Related papers