172 Impact of age on interventions and survival in people with motor neuron disease in Scotland

IntroductionMotor neuron disease (MND) is rapidly progressive and largely fatal. The National Institute for Health and Care Excellence guidelines (2016) outline best practice for symptomatic interventions including riluzole, gastrostomy, and non-invasive ventilation (NIV). We aimed to investigate the impact of age on interventions and survival in MND using data from the Scottish MND register (CARE-MND), hypothesising these factors may be impacted by increasing age.MethodsWe interrogated the CARE-MND database for incident cases in Scotland diagnosed between 01-Jan-2015 to 31-Dec-2020. Survival was compared in different age cohorts using Kaplan-Meier curves and log-rank test. Management was compared in different age cohorts using Chi-squared test.Results828 individuals were included (median age at diagnosis 68.7 years (interquartile range 61.4-76.1)). We investigated age cohorts of <40, 40-60, 60-80, and >80 years. Median survival from diagnosis in each cohort was 24 months, 18 months, 11 months, and 4.5 months respectively (p<0.001). Riluzole, NIV and gastrostomy were implemented least in the oldest group (p<0.05).ConclusionsOur data supports reduced survival of MND with increasing age, together with lower rates of riluzole prescribing, NIV use, and gastrostomy insertion, and offer insights into how care may be optimised in line with national guidelines.