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Sekiya et al1 recently reported that patients with late-onset multiple system atrophy (LO-MSA) (>75 years) show poor prognosis with median survival time of 3 years, which is significantly shorter than in those with usual-onset MSA (UO-MSA) (4.8 vs 7.9 and 3.9 vs 7.5 years, respectively). Among 276 MSA cases (193 in an autopsy cohort and 83 in a clinical cohort), LO-MSA accounted for 8% and 5%, respectively. The authors emphasised that clinical diagnosis of MSA may be difficult in elderly individuals due to the paucity of autonomic symptoms, whereas all LO-MSA patients presented with initial motor symptoms …
Contributors KAJ is the sole author.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.