Over half of people with multiple sclerosis (pwMS) are aged over 50. There is an urgent need for evidence-based treatment and earlier detection of disability progression in older pwMS. Whilst existing disease modifying therapies (DMTs) have demonstrated efficacy for inflammatory aspects of MS at early disease stages, their effectiveness in neurodegeneration at later stages of MS is limited. Combined with the greater risk of events such as infections and malignancy with age, there are concerns about using DMTs to treat older pwMS. Current clinical decision-making can be inconsistent, opinion-based and may expose older pwMS to unnecessary treatment.
Dr Yi Chao Foong and his team aim to establish the effectiveness of DMTs in older pwMS. They will also investigate the risk of side effects related to DMTs in older pwMS, and subsequent risk of disability progression. Understanding the balance between therapeutic benefits and risks is crucial for the use of DMTs in this population. The team also aims to identify digital monitoring tools that may predict early identification of progression or treatment failure, ultimately improving patient outcomes.
Over the past year, Dr Foong and his team have continued to improve understanding of how best to care for older people living with MS, while also developing new ways to monitor disease progression. Their research has shown that highly effective DMTs remain beneficial in older people with MS, who now represent the majority of the MS population.
The team has also been involved in developing and testing digital tools. These tools can be used on smartphones and computers at home to monitor symptoms such as thinking skills and hand function. These approaches have the potential to make it easier to track changes over time and support more personalised care for people living with MS.
In addition, Dr Foong has secured further research funding to support new projects focused on the earlier detection of MS and improving access to magnetic resonance imaging (MRI). He continues to work with large MS data registries to better understand how treatments perform in real-world settings. Recent findings from this work suggest that although relapses may become less frequent with age, their impact can be more severe in older adults, highlighting the importance of effective treatment and ongoing monitoring.
Over the next 12 months, Dr Foong and his team will continue their work to better understand MS in older adults, including investigating very late-onset MS, treatment safety, and the impact of relapses with ageing.
Foong, Y. C., Merlo, D., Gresle, M., Buzzard, K., Horakova, D., Havrdova, E. K., Kalincik, T., Roos, I., Hodgkinson, S., Lechner-Scott, J., Lugaresi, A., Weinstock-Guttman, B., Ozakbas, S., Surcinelli, A., Foschi, M., Boz, C., Khoury, S. J., Yamout, B., Laureys, G., Blanco, Y., … Study Group, M. (2025). Moderate-high efficacy disease-modifying therapies reduce relapse risk in late-onset multiple sclerosis. Journal of neurology, neurosurgery, and psychiatry, 97(1), 50–58. https://doi.org/10.1136/jnnp-2025-336513
Updated 31 March 2026
$225,000
2025
3 years
Current project
