Modifiable Risk Factors of Dementia in Older Adults With Epilepsy: An Opportunity to Flatten the Curve?

Abstract

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Epilepsy, Cardiovascular Risks, and Dementia: A Ménage à Trois

“… 11 Thus, it has been proposed that epilepsy in itself may contribute to WMH which may represent relevant biological substrates underlying cognitive decline in PWE. 10 , 12 Surprisingly, Tai et al did not find a difference in WMH in those with and without epilepsy. However, the findings of reduced hippocampal and gray matter volume in PWE by the authors are consistent with existing literature.…”

“…The current study adds to the growing evidence that PWE is more likely to develop dementia and that this risk is substantially magnified in the presence of cardiovascular risks. Early screening and targeted interventions toward modifiable cardiovascular risks may offer effective prevention strategies and an “opportunity to flatten the curve” 12 in delaying dementia onset in the aging population of PWE.…”

Late-Onset Epilepsy: A Distinct Entity that Begins and Ends With the Associated Comorbidities

“… 6 , 7 This intertwining of LOE and comorbidities of stroke and dementia suggests a triangulated relationship between vascular, neurodegenerative, and epileptic pathologies. 8 With the confluence of such factors that are known contributors to increased mortality in the general population, it is only natural to wonder about the mortality risk among individuals with LOE and the associated causes of death, especially given its distinctive etiopathogenesis. The article by Johnson et al 9 reviewed here tries to answer these questions.…”

“…These factors contribute to increased cerebrovascular and cardiovascular risk, which, in turn, elevates the risk of LOE, and thereby, mortality. 1 , 8 Therefore, it seems logical that early interventions to address the modifiable vascular risk factors could potentially break the vicious cycle of LOE, stroke, dementia, and death in our growing elderly population. Although the current study’s findings need replication in other populations, it seems that we are at a point where emerging, robust scientific data with clear biological plausibility is signaling that LOE is a harbinger of increased stroke, dementia, and mortality risk.…”