Myasthenia gravis in the elderly

The prevalence of myasthenia gravis (MG) in people over 50 years of age is increasing, mainly because of the increase in the percentage of people aged 65 years and over in society. The clinical symptoms are the same as in early onset, but may be more difficult to detect in the elderly. Most MG patients with symptom onset after 50 years of age have thymic atrophy. Approximately 10–15% of all patients with MG have a thymoma. Antibodies to non-acetylcholine receptors, such as titin and the ryanodine receptor, are common in early-onset MG thymoma, and more than 40% of patients with late-onset MG have such antibodies. The outcome after thymectomy in MG is generally less favorable in patients over 45 years of age. Standard nonsurgical therapy for late-onset MG follows a similar pattern as for early onset.