Complications and Conditions of Multiple Sclerosis in Seniors
Multiple sclerosis (MS) is an incurable degenerative disease that affects the myelin sheath around nerve cells.
MS is thought to be an autoimmune disorder, where the body’s immune system attacks the central nervous system (CNS), which includes the brain, the spinal cord, and the optic nerves. The immune system does this by causing inflammation that damages the myelin, the cells the make myelin, and often the nerve fibers themselves. When this damage occurs, transmissions within the CNS are altered or stopped, causing a myriad of neurological symptoms. The damaged areas develop scar tissue; multiple sclerosis means multiple areas of scarring. The impact of MS is unpredictable; no two patients are alike. Each patient’s symptoms are determined solely upon which nerves their MS attacks and upon the frequency and severity of the attacks.
The exact cause of MS is not known. Scientific research into causes and triggers of MS falls into four general categories:
- Immunology. MS is considered an autoimmune disorder. It’s known that T cells and B cells are involved in the abnormal immune response seen in MS patients, but research continues in discovering what sets the response in motion and how to slow or stop it. Researchers are also searching for other cells and processes that might be involved with MS.
- Epidemiology. Epidemiologists are actively pursuing research into incidents of MS within specific groups of people. Geography, race, ethnicity, age, and lifestyle are among the many factors being considered as possible triggers for developing MS. For example, MS is known to occur at higher rates in geographical locations that are farther from the equator. Correlations between early childhood obesity, smoking, and low levels of vitamin D have also been posited as possible triggers for MS.
- Genetics. MS is not a genetic disorder; an MS gene has not been identified. That said, there does seem to be an inheritable genetic risk for developing MS.
- Infectious agents. The disease process of MS involves the body attacking itself; an outside agent like a bacteria or virus does not destroy myelin. However, it’s possible that an infectious agent could be involved in triggering the development of MS. Scientists are investigating a number of viruses and bacteria to determine if they are associated with MS.
Understanding the causes and triggers of MS will help in the development of more effective treatments and will ultimately lead to discovering ways to cure or, better yet, prevent the disease.
Diagnosing Multiple Sclerosis
There is no definitive list of symptoms, physical findings, or lab tests that can determine if a patient has MS. However, the following are characteristics of clinical findings in patients experiencing the early signs of multiple sclerosis:
- Sensory symptoms in the face or limbs
- Vision loss in one eye
- Recent onset muscle weakness
- Double vision
- Balance problems, dizziness, and vertigo
- Gait changes
- Sensations down the back or limbs upon neck flexion that feel like electric shocks
- Bladder control problems
Patients with MS experience symptoms when the transmission of nerve signals along the CNS is disrupted. Symptoms vary from person to person, depending on the location of the damage. As a result, signs and symptoms of multiple sclerosis alone are not sufficient to diagnose MS. A definitive MS diagnosis requires both evidence visible via MRI of at least two areas of damage on the CNS that have occurred at different times and the exclusion of other explanations for symptoms.
Multiple Sclerosis Complications
MS can affect every major function in the body, so it’s not surprising that living with MS is complicated. The following are examples of challenges MS patients face:
- Bladder and bowel dysfunction – MS can cause problems like incontinence, constipation, and urinary retention.
- Cognitive dysfunction – While dementia is not typically associated with MS, other cognitive impairments are frequent, including difficulties with focus, executive functioning, short-term memory, word recall, abstract conceptualization, and impaired information processing speed.
- Vision impairment – Vision changes occur as MS progresses. Complications include unilateral vision loss, blurry vision, double vision, uncontrolled eye movements, and complete vision loss.
- Sensory impairment – MS patients regularly experience numbness and tingling in their extremities, making everyday tasks a challenge.
- Depression -Depression is common among MS patients.
- Fatigue – MS patients frequently experience fatigue that is unrelated to their level of activity.
- Difficulty walking – A variety of nerve issues can affect a patient’s ability to walk, including spasticity, muscle weakness, fatigue, numbness and tingling, and vision loss.
- Infection – Many MS treatments include immunosuppressive therapies designed to slow or stop the body’s immune response. This is tricky; since MS is an immune disorder, stopping the immune system from attacking the myelin is critical. But hampering the immune system also leaves patients more vulnerable to infection.
- Complications from corticosteroids – Short-term use of corticosteroids is the best way to help an MS relapse go away quickly, but corticosteroids are rough on the body and cause lots of unpleasant side effects, including pressure behind the eyes, weight gain, fluid retention, and high blood pressure as well as memory and mood issues.
- Venous thromboembolism (VTE) – VTE is a blood clot that causes a blockage. Steroid use, low mobility, and muscle stiffness are all risk factors for developing VTE, all of which make MS patients prime candidates.
Seniors and Multiple Sclerosis
A cursory glance through the complications of living with MS makes it easy to see why this disease poses a challenge for seniors. For seniors and caregivers, it’s often difficult to distinguish between symptoms of MS and symptoms of aging. This makes it very hard for health care providers to determine if MS is active or progressing, making choosing and evaluating treatment protocols especially challenging. Seniors with MS require special attention, often around the clock. Care involves the following:
- Medication management to make certain drug regimens are followed carefully especially in the face of cognitive impairment
- Physical therapy and exercise to minimize muscle stiffness and to prevent VTEs
- Light housework, cooking, and shopping to prevent injury, maintain good nutrition, and keep seniors living at home as long as possible
- Assistance with personal care – regular tasks such as toileting and bathing can be monumental challenges for senior MS patients
- Regular companionship to keep seniors mentally healthy
- Palliative care to alleviate discomfort
As MS treatments improve, more and more patients with MS are living into their senior years. The professional caregivers at 24 Hour Home Care are here to provide specialized at-home care for seniors living with MS. Our caregivers understand the complexities facing older MS patients and are committed to providing competent, compassionate care designed to help patients maintain their quality of life. Call today to learn more about our in-home MS care services.