title: Increasing age at disability milestones among MS patients in the MSBase Registry.
abstract: OBJECTIVE
  To analyze time-trends in age at disability milestones among MS patients who were enrolled into the MSBase International Registry during 1996-2010 period.
  
  
  METHODS
  We used linear regression to describe the relationship between mean age at major EDSS benchmarks and calendar time. We then assessed time-trend in age at initial EDSS rating with a three level linear growth model specifying that patients were nested within each of 20 participating countries. The model estimated the average of time-trends in mean age at initial clinical assessment within each country while controlling for patients' EDSS and sex in each country. Analyses were repeated in subsamples of patients diagnosed according to Poser or McDonald criteria.
  
  
  RESULTS
  The MSBase Registry contained data on 11,108 MS patients enrolled between 1996 and 2010 who fulfilled our inclusion criteria. During the 1996-2010 period, enrollment age for patients with EDSS 4/4.5 increased by 7.9 years, from 43 to 51 years (p<0.001), and for EDSS 6/6.5 - by 4.9 years, from 48 to 53 year (p<0.001). These trends were consistent across 20 investigator countries and were observed in Poser-diagnosed as well as McDonald-diagnosed patient subsets.
  
  
  CONCLUSIONS
  The more recent MSBase enrollees in each of the mild-to-moderate disability strata were significantly older than earlier enrollees. Possible explanations for this phenomenon are discussed.
authors.affiliation: NYU-Multiple Sclerosis Care Center, Department of Neurology, NYU School of Medicine, New York, NY 10003, USA. ilya.kister@gmail.com
authors.forename: Ilya
authors.initials: I
authors.lastname: Kister
authors.forename: Eric
authors.initials: E
authors.lastname: Chamot
authors.forename: Gary
authors.initials: G
authors.lastname: Cutter
authors.forename: Tamar E
authors.initials: TE
authors.lastname: Bacon
authors.forename: Vilija G
authors.initials: VG
authors.lastname: Jokubaitis
authors.forename: Stella E
authors.initials: SE
authors.lastname: Hughes
authors.forename: Orla M
authors.initials: OM
authors.lastname: Gray
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Guillermo
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Francois
authors.initials: F
authors.lastname: Grand'Maison
authors.forename: Pierre
authors.initials: P
authors.lastname: Duquette
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lugaresi
authors.forename: Pierre
authors.initials: P
authors.lastname: Grammond
authors.forename: Cavit
authors.initials: C
authors.lastname: Boz
authors.forename: Raymond
authors.initials: R
authors.lastname: Hupperts
authors.forename: Thor
authors.initials: T
authors.lastname: Petersen
authors.forename: Giorgio
authors.initials: G
authors.lastname: Giuliani
authors.forename: Celia
authors.initials: C
authors.lastname: Oreja-Guevara
authors.forename: Gerardo
authors.initials: G
authors.lastname: Iuliano
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lechner-Scott
authors.forename: Roberto
authors.initials: R
authors.lastname: Bergamaschi
authors.forename: Maria Edite
authors.initials: ME
authors.lastname: Rio
authors.forename: Freek
authors.initials: F
authors.lastname: Verheul
authors.forename: Marcela
authors.initials: M
authors.lastname: Fiol
authors.forename: Vincent
authors.initials: V
authors.lastname: Van Pesch
authors.forename: Mark
authors.initials: M
authors.lastname: Slee
authors.forename: Helmut
authors.initials: H
authors.lastname: Butzkueven
authors.forename: Joseph
authors.initials: J
authors.lastname: Herbert
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000453:epidemiology* / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology* / Q000503:physiopathology; D012042:Registries