The association between dementia and epilepsy: A systematic review and meta‐analysis

Subota, Ann; Pham, Tram; Jetté, Nathalie; Sauro, Khara M.; Lorenzetti, Diane; Holroyd‐Leduc, Jayna

doi:10.1111/epi.13744

Cited by 103 publications

(77 citation statements)

References 41 publications

(106 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The etiological profile of epilepsy in the elderly may contribute to the excess health care expenditure in this population. Cerebrovascular diseases and dementia, for example, may account altogether for nearly 70% of all causes of epilepsy with identified underlying cause in elderly individuals . The relationship between epilepsy and stroke is bidirectional.…”

Section: Discussionmentioning

confidence: 99%

“…Dementia including Alzheimer's disease and epilepsy are common in elderly patients. Moreover, dementia may increase the risk of epilepsy by up to 8‐fold . The medical cost of dementia is already high, with annual cost per person ranging from $41 689 to $56 290 .…”

Section: Discussionmentioning

confidence: 99%

“…Cerebrovascular diseases and dementia, for example, may account altogether for nearly 70% of all causes of epilepsy with identified underlying cause in elderly individuals. 5,27 The relationship between epilepsy and stroke is bidirectional. Stroke is a known risk factor for developing epilepsy, and patients aged 60 years or older with a first seizure but no history of stroke have almost 3 times higher odds of having a subsequent stroke, indicating that epilepsy may be an early manifestation of cerebrovascular disease.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, dementia may increase the risk of epilepsy by up to 8-fold. 5 The medical cost of dementia is already high, with annual cost per person ranging from $41 689 to $56 290. 33 In the current study, the incremental cost of dementia in elderly individuals with epilepsy versus those without epilepsy was high ($3794; 95% CI = $2212-$5375).…”

Section: Discussionmentioning

confidence: 99%

“…Beside a high prevalence and incidence, older individuals with epilepsy, although at lower risk of sudden death than their younger counterparts, have a substantially higher mortality rate than those without epilepsy in the same age group . Furthermore, in this age group, neurologic, psychiatric, and medical comorbidities are common . Elderly individuals are also more likely to be disabled by epilepsy .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Health care expenditures among elderly patients with epilepsy in the United States

2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Health care expenditures among elderly patients with epilepsy in the United States

2018

View full text Add to dashboard Cite

show abstract

Association of Dementia Risk With Focal Epilepsy and Modifiable Cardiovascular Risk Factors

et al. 2023

View full text Add to dashboard Cite

ImportanceEpilepsy has been associated with cognitive impairment and potentially dementia in older individuals. However, the extent to which epilepsy may increase dementia risk, how this compares with other neurological conditions, and how modifiable cardiovascular risk factors may affect this risk remain unclear.ObjectiveTo compare the differential risks of subsequent dementia for focal epilepsy compared with stroke and migraine as well as healthy controls, stratified by cardiovascular risk.Design, Setting, and ParticipantsThis cross-sectional study is based on data from the UK Biobank, a population-based cohort of more than 500 000 participants aged 38 to 72 years who underwent physiological measurements and cognitive testing and provided biological samples at 1 of 22 centers across the United Kingdom. Participants were eligible for this study if they were without dementia at baseline and had clinical data pertaining to a history of focal epilepsy, stroke, or migraine. The baseline assessment was performed from 2006 to 2010, and participants were followed up until 2021.ExposuresMutually exclusive groups of participants with epilepsy, stroke, and migraine at baseline assessment and controls (who had none of these conditions). Individuals were divided into low, moderate, or high cardiovascular risk groups based on factors that included waist to hip ratio, history of hypertension, hypercholesterolemia, diabetes, and smoking pack-years.Main Outcomes and MeasuresIncident all-cause dementia; measures of executive function; and brain total hippocampal, gray matter, and white matter hyperintensity volumes.ResultsOf 495 149 participants (225 481 [45.5%] men; mean [SD] age, 57.5 [8.1] years), 3864 had a diagnosis of focal epilepsy only, 6397 had a history of stroke only, and 14 518 had migraine only. Executive function was comparable between participants with epilepsy and stroke and worse than the control and migraine group. Focal epilepsy was associated with a higher risk of developing dementia (hazard ratio [HR], 4.02; 95% CI, 3.45 to 4.68; P &lt; .001), compared with stroke (HR, 2.56; 95% CI, 2.28 to 2.87; P &lt; .001), or migraine (HR, 1.02; 95% CI, 0.85 to 1.21; P = .94). Participants with focal epilepsy and high cardiovascular risk were more than 13 times more likely to develop dementia (HR, 13.66; 95% CI, 10.61 to 17.60; P &lt; .001) compared with controls with low cardiovascular risk. The imaging subsample included 42 353 participants. Focal epilepsy was associated with lower hippocampal volume (mean difference, −0.17; 95% CI, −0.02 to −0.32; t = −2.18; P = .03) and lower total gray matter volume (mean difference, −0.33; 95% CI, −0.18 to −0.48; t = −4.29; P &lt; .001) compared with controls. There was no significant difference in white matter hyperintensity volume (mean difference, 0.10; 95% CI, −0.07 to 0.26; t = 1.14; P = .26).Conclusions and RelevanceIn this study, focal epilepsy was associated with a significant risk of developing dementia, to a greater extent than stroke, which was magnified substantially in individuals with high cardiovascular risk. Further findings suggest that targeting modifiable cardiovascular risk factors may be an effective intervention to reduce dementia risk in individuals with epilepsy.

show abstract

Epilepsy and Related Disorders

Duncan,

Sander,

Alim‐Marvasti

et al. 2024

Neurology

View full text Add to dashboard Cite

The association between dementia and epilepsy: A systematic review and meta‐analysis

Abstract: There are significant gaps in knowledge regarding the epidemiology of epilepsy in dementia and vice versa. Accurate estimates are needed to inform public health policy and prevention, and to understand health resource needs for these populations.

Cited by 103 publications

References 41 publications

Health care expenditures among elderly patients with epilepsy in the United States

Health care expenditures among elderly patients with epilepsy in the United States

Association of Dementia Risk With Focal Epilepsy and Modifiable Cardiovascular Risk Factors

Epilepsy and Related Disorders

Contact Info

Product

Resources

About