Aging with multiple sclerosis.

The chronic and progressive nature of MS may be overwhelming to the patient and the family. It is vital for the clinician to develop a system of periodic evaluations and interventions that monitor the disease and address the effects on the patient's physical, psychologic, social, and vocational functioning. MS patients are susceptible to other diseases of aging, such as stroke, cancer, heart disease, and diabetes, and need to be evaluated and treated for these conditions. Obtaining appropriate routine medical care may become difficult in less mobile patients because many clinicians' offices are unable to accommodate handicapped patients. Careful coordination and referral to handicap-accessible centers may be required to ensure adequate treatment. Nearly half of MS patients die from complications of their disease. Other major causes of mortality are malignancy (16%), suicide (15%), and myocardial infarction (11%). Age-appropriate cancer screenings and cardiac evaluation are necessary. Depression is an important factor in geriatric MS patients despite the fact that most MS patients have an easier time adjusting to the aging process than the general population. There are many unanswered questions for the older MS population due to the paucity of research, but future studies may rectify this situation. Although there is no cure for MS, the clinician can play a key role in helping the patient and family adapt to the illness and improve their quality of life. Resources are available for the clinician, the patient, and family members.