Cognitive problems in older MS patients liked to disability, not ageing

MS cognitive problems are more common in older adults, but a new study suggests disability, not age, is the main driver.

The research found that while older people with MS had more prevalent and severe cognitive problems, particularly in information-processing speed and memory, age was not directly associated with impairment after adjustments.

Instead, greater disability emerged as the main predictor of cognitive difficulties in older patients.

The study, conducted by researchers in Argentina, evaluated 339 people with MS. Of these, 256 were aged 50 or younger, while 83 were older adults aged 51 to 77. Progressive forms of MS were more common in older patients, who also had greater disability levels.

Results showed that significantly more older MS patients than younger ones were cognitively impaired (59 per cent versus 42.6 per cent).

The researchers wrote: “Taken together, these findings indicate that the cognitive differences observed between age groups may largely reflect the cumulative impact of disease-related factors rather than ageing itself. This reinforces the interpretation that lifelong disease burden, rather than chronological age, is the primary driver of cognitive decline in older [people with] MS.”

Among older MS patients, the most impaired cognitive function was information-processing speed, followed by deficits in verbal, working and visual memory. Executive function, which refers to the skills used to manage everyday tasks such as making plans and solving problems, was also affected.

The team also found that having higher education or occupational attainment acted as a protective factor, supporting the cognitive reserve hypothesis. This idea suggests that individuals with higher levels of education or who engage in cognitively stimulating activities are better able to cope with changes in the brain.

Disease duration, depression, anxiety and fatigue showed no significant relationships with cognitive challenges.

The researchers concluded: “This study provides solid empirical evidence on cognitive impairment in older people with multiple sclerosis. These results reinforce the need to implement age-sensitive diagnostic and therapeutic strategies that take into account individual trajectories and the clinical course of the disease.”