Activities of daily living are associated with outcomes of epilepsy treatment in elderly patients

Abstract

Aim: Controlling epileptic seizures in elderly populations is widely considered to be relatively easy, but we hypothesized that the lifestyles of elderly individuals may affect the outcomes of epilepsy treatment. The purpose of this study was to review the activities of daily living (ADL) of elderly individuals with epilepsy and compare them with the outcomes of epilepsy treatment. Methods: Of the 177 patients ≥65 years old who were referred to our epilepsy centre, epilepsy was diagnosed in 84. ADL and treatment outcomes were then reviewed, with ADL classified into three levels: ADL I, without disability; ADL II, disabled only in some instrumental ADL; and ADL III, disabled in some basic ADL. Epilepsy syndromes and use of anti-seizure drugs were also evaluated. Results: Forty-five patients (53.6%) achieved freedom from seizures, 23 (27.4%) achieved ≥80% but <100% reduction in seizures, 5 (6%) achieved ≥50% but <80% reduction in seizures, and 11 (13.1%) achieved <50% reduction in seizures. Thirty-five patients (81.4%) with ADL I achieved freedom from seizures, compared with seven patients with ADL II (28.0%) and three patients with ADL III (19.0%). A significant difference was evident among the three groups (F = 6.145, P = 0.003). Conclusions: ADL should be taken into account when an epilepsy treatment is being selected.

The Effect of Dual Sensory Impairment and Multimorbidity Patterns on Functional Impairment: A Longitudinal Cohort of Middle-Aged and Older Adults in China

“…Each item is rated on a 4-point scale (1 = activity can be performed without any help; 4 = completely unable to perform activity without help). Participants who need help to perform at least one of these ADLs and IADLs was classified as "ADL limitations" and "IADL limitations", respectively (Fujimoto et al, 2020). Therefore, the cut-off scores for ADLs and IADLs were 6 and 5 in this study.…”

Replacement of Valproic Acid with New Anti-Seizure Medications in Idiopathic Generalized Epilepsy

“…These new ASMs are considered to incur fewer adverse effects (AEs) and offer higher tolerability [ 4 ], along with advantages including fewer drug–drug interactions and fewer negative impacts on cognitive function [ 5 , 6 ]. Old ASMs are still in use around the world [ 7 , 8 ], and the non-inferiority of new ASMs has been shown for some older ASMs [ 9 ].…”