title: Effect of gender on late-onset multiple sclerosis.
abstract: OBJECTIVE
  We aimed to examine the incidence and disease course of late-onset multiple sclerosis (LOMS) compared with adult-onset MS (AOMS) in our clinic cohort, stratified based on gender and race, since both have been reported as important modifiers of disease outcomes in MS.
  
  
  METHODS
  Patients with LOMS and AOMS were compared in terms of demographic characteristics and disease course characteristics. Combined effects were investigated with a logistic regression model. Time from disease onset to sustained Expanded Disability Status Scale (EDSS) score of 6 was investigated using an extension of log-rank test appropriate for interval-censored data.
  
  
  RESULTS
  Some 7.96% of 4273 patients studied had an onset of MS after the age of 50 years (LOMS), and 1.33% experienced an onset after age 60. Progressive onset was more common in LOMS relative to AOMS. The proportion of women with progressive-onset disease was similar in AOMS and LOMS. Time to EDSS 6 was delayed in AOMS females compared with males; however, it was similar between males and females in the LOMS group.
  
  
  CONCLUSIONS
  Women with LOMS have a different trajectory in terms of disease progression than women with AOMS. The effect of menopause combined with race/ethnicity on the MS disease course requires further investigation.
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, USA.
authors.forename: Riley M
authors.initials: RM
authors.lastname: Bove
authors.forename: Brian
authors.initials: B
authors.lastname: Healy
authors.forename: Ann
authors.initials: A
authors.lastname: Augustine
authors.forename: Alexander
authors.initials: A
authors.lastname: Musallam
authors.forename: Taha
authors.initials: T
authors.lastname: Gholipour
authors.forename: Tanuja
authors.initials: T
authors.lastname: Chitnis
mesh_terms: D000328:Adult; D017668:Age of Onset; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D012737:Sex Factors