{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T08:42:24Z","timestamp":1786178544292,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forskningsradet for halsa, arbetsliv och valfard","doi-asserted-by":"publisher","award":["2015-00195 and 2019-00697"],"award-info":[{"award-number":["2015-00195 and 2019-00697"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsradet","doi-asserted-by":"publisher","award":["2016-02349 and 2020-01998"],"award-info":[{"award-number":["2016-02349 and 2020-01998"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Margaretha af Ugglas Foundation"},{"DOI":"10.13039\/501100006310","name":"Medicinska Forskningsradet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006310","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003792","name":"Hjarnfonden","doi-asserted-by":"publisher","award":["FO2020-0077, FO2024-0344"],"award-info":[{"award-number":["FO2020-0077, FO2024-0344"]}],"id":[{"id":"10.13039\/501100003792","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Late-onset multiple sclerosis (LOMS), defined as disease onset at or after 50\u2009years, is increasingly recognized and associated with distinct features. However, it remains unclear whether LOMS differs etiologically from adult-onset multiple sclerosis (AOMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To determine whether established MS risk factors differ between LOMS and AOMS and influence age at onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a Swedish population-based case\u2013control study including 3950 incident MS cases and 7340 controls. Cases were classified as LOMS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009396) or AOMS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093554). Associations between risk factors and LOMS and AOMS were estimated using logistic regression. Case-only analyses assessed associations with age at onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Most MS risk factors, including MS heredity,\n                      <jats:italic toggle=\"yes\">HLA-DRB1*15:01<\/jats:italic>\n                      , Epstein\u2013Barr nuclear antigen (EBNA)-1 antibody levels, smoking, and low sun exposure, were associated with both onset groups, with stronger effects in AOMS. Elevated body mass index at age 20\u2009years was associated with AOMS, while estimates in LOMS were imprecise. Case-only analyses showed no association with disease timing. Exposure distribution varied across birth cohorts, suggesting cohort effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Established MS risk factors appear to be more clearly related to disease susceptibility than to timing of onset. The broadly consistent risk factor profiles support a shared etiology, although modest differences cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261472320","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:13:31Z","timestamp":1785993211000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared etiology of late- and adult-onset multiple sclerosis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-8951","authenticated-orcid":false,"given":"Virginija Danylait\u00e9","family":"Karrenbauer","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Alfredsson","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6612-4749","authenticated-orcid":false,"given":"Anna Karin","family":"Hedstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1401483"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.102816"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005612"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208051"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10490-0"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.104506"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.50862"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-325676"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002075"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2025.111146"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09677-3"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20703"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22366"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aav7188"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1002877"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.052381"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209379"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/gene.2011.42"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-12047-9"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00184-3"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103361"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-12041-1"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261472320","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585261472320","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261472320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T07:49:42Z","timestamp":1786175382000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585261472320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":23,"alternative-id":["10.1177\/13524585261472320"],"URL":"https:\/\/doi.org\/10.1177\/13524585261472320","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"article-number":"13524585261472320"}}