Jean Griswold received her first multiple sclerosis diagnosis at age 39. However, that did not stop her from achieving amazing things in her 86 years, such as founding Griswold Home Care. Multiple sclerosis is when your immune system sends an abnormal response to your central nervous system. This ultimately attacks the nerve fibers and fatty tissue around your brain, spinal cord, and optic nerves, forming scar tissue. Eventually, there’s a distortion in the nerve impulses that travel to and from the spinal cord and brain, causing the disease’s symptoms.
There are four different types of multiple sclerosis:
- Relapsing-Remitting MS
- Affects 85% of those diagnosed with MS
- Flare-ups and relapses occur when new symptoms present themselves
- Eventually progresses to secondary progressive MS after a period of 10 to 20 years
- Secondary Progressive MS
- Symptoms worsen steadily over time, regardless of whether or not there are periods of remission and relapse
- Varies from person to person
- Even with treatment, an individual may not function as well as before
- Primary Progressive MS
- Affects 10% of those diagnosed with MS
- Symptoms gradually worsen over time with no periods of remission or relapse
- Progressive Relapsing MS
- Affects 5% of those diagnosed with MS
- Symptoms include a steady worsening of the disease from the very beginning with no remissions, just acute relapses
In honor of Multiple Sclerosis Awareness Month, let’s take a look at some basic facts about multiple sclerosis and review steps you can take while caring for your loved one.
Multiple Sclerosis: Age of Onset
Typically, the multiple sclerosis age of onset is between the ages of 20 and 50 but that does not mean multiple sclerosis in older adults is impossible. Many studies estimate that around 4% of multiple sclerosis patients get diagnosed after age 50. This low percentage is not because it’s a rarity in older adults. It’s actually because it is harder to diagnose due to a number of factors.
Late-onset multiple sclerosis is hard to diagnose in older adults for the following reasons:
- Researchers study MS in the younger-adult population more than the older adult population.
- Late-onset MS symptoms such as fatigue, vision changes, cognitive impairment, and balance issues are often mistaken for signs of normal aging.
- Symptoms can mimic stroke, major depressive disorder, Parkinson’s disease, dementia, and ALS.
- Magnetic resonance imaging (MRI) scans, which are commonly used to diagnose MS, may show white-matter brain damage consistent with MS and this may be interpreted as damage from vascular diseases common in older people.
Furthermore, this delayed diagnosis and treatment is why those with late-onset multiple sclerosis tend to have the worst outcome. Older adults also tend to reach a disability level faster with a median time of 6.5 years rather than younger adults with a median time of 12.8 years, according to a study in PLoS ONE.
Signs of Multiple Sclerosis in Adults
The following are some early symptoms of multiple sclerosis in adults:
- Bladder Issues
- Bowel Issues
- Difficulty Walking
- Speech Issues
- Vision Issues
- “Anxiety or MS…Scared”
- “Newbie with questions”
- “Depression and MS”
- “Taking meds through airport security?”
- “Scared of romance”
- “Am I just crazy?”
All of these questions have one thing in common: anxiety. On Griswold’s webinar The Invisible Side of Multiple Sclerosis, MS navigator Kelly Walker noted the symptom after seeing the common theme in discussion boards.
“It’s an unpredictable disease so for someone who’s newly diagnosed, of course there’s a lot of anxiety about what is this, what’s going to happen to me,” Walker said. “But because it is such an unpredictable disease, that anxiety is always present for a lot of people because, as we said, it affects your central nervous system. So basically anything in your body that has a nerve, then it can be affected pretty much at any time. So that anxiety seems to be present for a lot of people that I speak with that have MS because you just kind of don’t know what the next day might bring.”
Additionally, one should also be on the lookout for relapse signs of multiple sclerosis in adults. Most importantly, you should take all of your medications and listen to your doctor’s advice every time.
Multiple Sclerosis and Aging: MS in Older Adults
As we outlined earlier, multiple sclerosis is typically caught between the ages of 20 and 50. However, those younger patients eventually become older adults and the pain can be further exacerbated with age. Dr. Derrick Robertson, director of the MS program at the University of South Florida, and Dr. Larry Sherman, a professor of neuroscience at Oregon Health and Science University, noted the cognitive, physical, and emotional sides of multiple sclerosis aging.
When it comes to cognition, Sherman said if you experience deficits when you’re younger, the deficits associated with aging will be greater. “You start off with a deficit, and then you get hit with deficits associated with normal aging – or worse, dementia – resulting from processes unrelated to MS,” he said. “That is a greater challenge than most people have to face.”
As for physical side effects, Robertson said muscles can start to atrophy later in life especially if you are not moving regularly. This can cause patients to have difficulty walking or performing other physical functions. “It can be very disabling later in life, especially when the upper extremities have poor coordination and weakness,” Robertson said. “That limits daily function.” This loss of independence can also lead to social isolation, which is a risk factor for depression later in life.
However, depression and anxiety can also become more manageable. In addition to the detriments, Robertson noted older people are better equipped to handle the emotional side effects. “The ability to cope later in life seems to be better,” he said. “I’m of the opinion that it’s because it’s a gradual decline over the years. People learn that with the right treatment, you can find a new normal.”
To combat some of the negative side effects, there are plenty of care strategies for multiple sclerosis, which we will review in the next section.
Multiple Sclerosis Care Plan
Multiple sclerosis home care involves three important aspects: diet, staying active, and home modification. Let’s take a look at how these aspects can be incorporated into your multiple sclerosis care plan.
- Eliminate dairy and other saturated fats.
- Omega-3 fat found in fish has been proven to have a positive outcome.
- Overall, a well-balanced diet can help reduce fatigue and bowel and bladder issues.
- Staying Active
- A simple 15 minutes of yoga can fight off spasticity.
- Weight-bearing exercises, such as jogging, can strengthen your bones.
- Cardio workouts, such as swimming, biking, walking, pilates, and yoga have been shown to slow the progression of MS. Consider creating a home exercise program for multiple sclerosis.
- Home modification
- Get rid of ground clutter such as throw rugs, pet toys or shoes.
- For pets, consider investing in pet training or attaching bells on their collars to ensure they aren’t tripping hazards.
- Staircases should be well lit with handrails, non-skid surfaces, and secure floorboards. Keep flashlights in drawers at the top and bottom of the stairs in case of power outages.
- For the bathroom, consider installing a tub seat, a raised toilet seat, and grab bars for both areas.
- Make sure your home is wheelchair accessible.
- For more information, refer to the National Multiple Sclerosis Society home modification program.
Caring for someone with multiple sclerosis can also be difficult for the caregiver, so it’s important to practice your own self-care. Check out some tips at this link.
Now that we know more about multiple sclerosis, it’s time to make the environment friendly for your loved one. Of course, you should always talk to a doctor to discuss the best home remedies for multiple sclerosis symptoms. For more tips and information, refer to the worksheets below.