Cognition, mood and quality-of-life outcomes among low literacy adults living with epilepsy in rural Kenya: A preliminary study

Abstract

Epilepsy is frequently associated with neurocognitive impairments, mental health, and psychosocial problems but these are rarely documented in low- and middle-income countries. The aim of this study was to examine the neurocognitive outcomes, depressive symptoms, and psychosocial adjustments of people with epilepsy (PWE) in Kilifi, Kenya. We evaluated the impact of these outcomes on health-related quality of life. Self-report, interviewer-administered measures of depression (Major Depression Inventory) and quality of life (RAND SF-36) were administered to 63 PWE and 83 community controls. Neurocognitive functioning was assessed using Raven's Standard Progressive Matrices, Digit Span, and Contingency Naming Test. The results show that PWE have poorer scores for executive function, working memory, intelligence quotient (IQ), depression, and quality of life than controls. Twenty-seven (27%) of PWE had depressive symptoms, which was significantly greater than in controls (6%); P < 0.001. Quality-of-life scores were significantly lower in PWE with depressive symptoms than in those without depressive symptoms (Mean QoL scores (standard deviation (SD)): 46.43 (13.27) versus 64.18 (17.69); P = 0.01. On adjusted linear regression models, depression affected total quality-of-life scores (P = 0.07) as well as individual health indicator domains touching on pain (P = 0.04), lethargy/fatigue (P = 0.01), and emotional well-being (P = 0.02). Our results show that epilepsy is associated with a significant burden of mental health and neurocognitive impairments in the community; however, community-based studies are needed to provide precise estimates of these disorders.

Quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia: A cross-sectional study

“…Having moderate to severe anxiety and depression, and other co-morbidities resulted in decreased quality of life in epileptic patients. This finding is supported by studies conducted in China [ 52 ], Ethiopia [ 31 , 49 ], and Kenya [ 53 ]. This could be due to the effect of these problems on quality of life, particularly, in the domains of lethargy/fatigue, and emotional well-being [ 53 ].…”

Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

“…The association between comorbid mental disorders and poor quality of life is consistent with the findings of previous studies carried out in both high-income and LMICs [ 7 , 12 , 13 , 17 ]. Higher seizure frequency has also been shown to be associated with poor quality of life [ 12 ], although some studies found that comorbid mental disorders existed despite good control of seizures [ 12 ].…”

The Oscillatory Basis of Working Memory Function and Dysfunction in Epilepsy

“…Working memory impairment is well-documented in both children ( Hernandez et al, 2002 ; Myatchin and Lagae, 2011 ; Sherman et al, 2012 ; Braakman et al, 2013 ; Longo et al, 2013 ) and adults ( Hermann and Seidenberg, 1995 ; Black et al, 2010 ; Mwangala et al, 2018 ) with epilepsy. WM impairment is common across epilepsy types, manifesting in primary generalized epilepsies ( Swartz et al, 1994 ), temporal lobe epilepsy (TLE) ( Stretton and Thompson, 2012 ), and frontal lobe epilepsy (FLE) ( Swartz et al, 1994 ).…”