Modulation of the immunological and neuroinflammatory microenvironment in older people with multiple sclerosis

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Aging alters multiple sclerosis (MS) pathobiology, shifting from relapse-driven inflammation to chronic neuroinflammation and neurodegeneration.
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Immunosenescence and 'inflammaging' contribute to microglial activation and progression of MS independent of relapse activity.
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Age impacts disability trajectories, cognitive decline, and comorbidities in older individuals with multiple sclerosis.
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The review discusses the safety and efficacy of disease-modifying therapies in older pwMS, including de-escalation strategies.
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Emerging treatments for older pwMS include Bruton's tyrosine kinase inhibitors and lifestyle-based interventions.

Frontiers In Immunology

by Oreja-Guevara, Celia , Meuth, Sven G, Grigoriadis, Nikolaos , Vermersch, Patrick , Hartung, Hans-Peter , Sorensen, Per Soelberg , Leocani, Letizia , Schmierer, Klaus , Gold, Ralf , Fernández, Óscar Fernández
May 19, 2026

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