b'Medicine & ResearchMMSSaannddtthheeOOllddeerrPPooppuullaattiioonnSSccrreeeenniinnggss,,pphhyyssiiccaallaaccttiivviittyy,,aannddaaddaappttaattiioonnccrruucciiaalltot ohheeaalltthhyyaaggiinnggBy Marijean Buhse, Ph.D., RN, NP-C, MSCN, FAAN Multiple sclerosis is an inammatory and65 have two or more chronic diseases. The demyelinating disease of the central nervouspresence of two or more diseases in a person system. Most people present with relapsingat one time, called comorbidities, are much forms of MS and are diagnosed between agesmore common in older adults than younger 18-40, although diagnosis can be earlier orones. In persons with MS, the immune system later in some. Regardless of age or type of MSis already dysregulated and with aging they when diagnosed, it is no longer only a diseasearejustassusceptibletodiseaseastheir of early adulthood. Research shows that MS,aging counterparts. once thought to shorten lifespan, does not, andCpersons diagnosed in their 20s may live atCoommoorrbbiiddiittyyaannddMMSSleast 50 years with this disease. It is estimatedSignicant improvements in treating MS and that more than 25 percent of persons livingcomorbidities have increased life expectancy. with MS are adults older than 55.Disease-modifying therapies have changed As people age, the immune system agesthe course of MS, in that early and continuous also. The role of the immune system is to protecttreatment may prevent permanent damage the body against disease from foreign andto the central nervous system. However, little harmful substances. This includes, but is notisknownabouttreatingolderadultswith limited to, bacteria, viruses, cancer cells, andDMTs. Clinical trials for all approved drugs other microorganisms that can cause disease.included few persons over the age of 55, so it With aging, the immune system is less ableis difficult to conrm whether these treatments toadequatelyrespondtodiseaseandlessare safe and effective. Studies are ongoing to able to repair when a person gets a disease.determine if or when an older person should There is an increased risk of getting sick andbe taken off a DMT because of aging and slower healing. It is thought that because of thecomorbidity. aging of the immune system, chronic diseasesComorbidities treated in older persons with such as cancer, heart disease, and autoimmuneMS may differ slightly from the general aging diseases such as diabetes are more frequentpopulation. For instance, the most frequent in older adults.comorbidity in the aging population is arthritis. In 2021, the National Council on AgingIn MS, the most common comorbidities include reported that 68 percent of people older thancardiovascular disease (e.g., vascular disorders, 15 msfocusmagazine.org'