title: The changing face of multiple sclerosis: Prevalence and incidence in an aging population.
abstract: OBJECTIVE
  To assess multiple sclerosis (MS) incidence from 1998 to 2007, and MS prevalence on 31 December 2007, in the province of Genoa, Italy.
  
  
  METHODS
  We identified MS cases diagnosed before 31 December 2007 by analyzing archives of hospitals with neurological or rehabilitation wards, the local Italian MS society, family doctor records and requests for oligoclonal band analysis on cerebrospinal fluid (CSF).
  
  
  RESULTS
  A total of 1312 MS patients were residing in the province of Genoa on the prevalence day; 431 (32.85%) were men and 881 (67.15%) were women; mean age was 50.6 (± 13.9). The overall crude MS prevalence rate was 148.5/100,000; 103.1/100,000 in men and 189.1/100,000 in women. The crude mean annual MS incidence rate was 6.6 cases/100,000 (4.4/100,000 men; 8.6/100,000 women). Mean age at diagnosis was 39.5 ± 12.3 (men: 39.9 ± 13.0; women: 39.3 ± 11.9). A mean annual incidence of 4 MS patients ≥ 60 was observed.
  
  
  CONCLUSIONS
  We observed an increased MS prevalence in the province of Genoa, compared to 1997. The mean age at diagnosis was relatively high (39 years old), 18% of our MS patients were over 65, and a notable incidence increase was seen in patients over 60. This has important implications, in terms of the need to organize the health system to better serve elderly MS patients, especially considering comorbidities and different medical needs of elderly MS patients; and to increase awareness within the medical community about the increasing risk of newly-presenting MS in the older population.
authors.affiliation: Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy csolaro@libero.it.
authors.forename: C
authors.initials: C
authors.lastname: Solaro
authors.affiliation: Research Department, Italian Foundation of Multiple Sclerosis, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ponzio
authors.affiliation: Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Moran
authors.affiliation: Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Tanganelli
authors.affiliation: Neurology Department - Lavagna Hospital, Genoa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pizio
authors.affiliation: Neurology Department, San Martino Hospital, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ribizzi
authors.affiliation: Neurology Department, Galliera Hospital, Genoa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Venturi
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa; Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Mancardi
authors.affiliation: Department of Life Science, University of Siena, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Battaglia
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D017678:Sex Distribution; D055815:Young Adult
keywords: Elderly; Italy; incidence; multiple sclerosis; prevalence