Aging with Multiple Sclerosis

Multiple Sclerosis (MS) is a neurological disease that affects the central nervous system which includes the brain and spinal cord; therefore, impacting everything that we do¹. MS causes an immune response to attack the brain and spinal cord leading to symptoms such as numbness, tingling, mood changes, memory problems, pain, fatigue, blindness and/or paralysis.¹ 

MS is a neurological disease that affects mobility. Unfortunately, the effects of both aging and MS can compound on each other and lead to greater mobility impairments compared to aging adults without MS. 

Effects of Aging on Mobility in those with MS:²

• Musculoskeletal Changes
  • Both older adults and those with MS: experience declines in strength and motor control
  • In those with MS: decreased nerve transmission from central nervous system to peripheral nerves that stimulate muscle contractions, will worsen with fatigue or heat
  • Declines in strength can lead to deconditioning, muscle atrophy, and maladaptive patterns of movement
• Sensory Changes
  • Both older adults and those with MS: peripheral nervous system becomes less efficient due to nerve ending atrophy and loss of myelin resulting in sensory loss
  • In those with MS: dysfunction in signal transmission, altered sensation is possible, will worsen with fatigue or heat
  • Sensory declines can impact movement due to delayed postural and balance responses, may lead to avoiding certain activities secondary to fear, increased incidence of tripping/falling
• Pain
  • Both older adults and those with MS: chronic pain can affect both but is more prevalent in those with neurological diseases & may or may not be related to tissue damage
    • Up to 30% adults without a neurological disease have chronic pain
    • Up to 85% of those with MS have chronic pain
• Cardiopulmonary Changes
  • Both older adults and those with MS: common diagnoses include high blood pressure, coronary artery disease, peripheral vascular disease, and decreased aerobic capacity
  • In those with MS: changes can lead to increased rate of deconditioning and muscle atrophy, detraining of balance systems, and impair functional mobility
• Mobility and Balance
  • In those with MS: walk similarly to those who are 20 years older as they are aging at an increased rate in terms of mobility
• Cognitive Changes
  • Both older adults and those with MS: cognitive impairments are common, both demonstrate decreases in memory recall, information processing, and executive functioning
  • In those with MS: impaired word recall but demonstrate intact recognition which is due to likely having intact encoding and storage but impaired retrieval of information
• Fatigue
  • In older adults: not a direct result of aging, instead it is related to other comorbidities of aging including muscle atrophy, deconditioning, polypharmacy, inefficient movement patterns
  • In those with MS: most common symptom
  • Fatigue can increase immobility, decrease exercise tolerance, and decrease social interaction

Both older adults and those with MS are susceptible to deconditioning which can lead to increased pain, muscle weakness, balance loss, cardiac changes, fatigue, and social isolation. Luckily, physical therapy can help improve all of these impairments!

If you are suffering from MS and are noticing a decline in any of these areas, contact Live Your Life today so that we can help to alleviate your symptoms and improve your overall quality of life.

Dr. Kristen Reed

Dr. Kristen Reed, DPT, GRS, CLT graduated in 2011 from University of Minnesota-Twin Cities with a B.S. in Kinesiology degree. She went on to graduate with a Doctorate of Physical Therapy from St. Catherine University (2015) and completed the Geriatric Clinical Residency program from the University of Minnesota- Twin Cities in 2016. She has spent her career working with primarily geriatrics in the Transitional Care/ Memory Care/ Long Term Care settings. Dr. Reed loves working with geriatrics and is passionate about helping them improve their quality of life. She loves being a therapist and watching her clients reach their goals.

She is kept busy with her husband and young daughter. She enjoys spending time with friends and family as much as possible. Her favorite activities are hiking in the summer and downhill skiing in the winter.

References

¹“What is MS?.” National Multiple Sclerosis Society, 19 March 2022, https://www.nationalmssociety.org/What-is-MS

²Karpatkin H, Cohen E, DiCarrado S, Muth S, Zervas M. Double Impact: Aging with a progressive neurological disease. Combined Sections Meeting. 04 February 2022.