Epilepsy in the Elderly: Incidence, Social Function, and Disability

Lühdorf, K.; Jensen, Louise Kruse; Plesner, Anne‐Marie

doi:10.1111/j.1528-1157.1986.tb03516.x

Cited by 89 publications

(48 citation statements)

References 22 publications

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“…Of the one to one-and-a-half year survivors in our study, 34% had had recurrent seizure, which is a little higher than other studies, which have reported recurrent seizures ranging from 11% to 28% in one to one-and-a-half years follow up. 4,9 Of those patients with a previous history of stroke in our study, recurrent seizures recurred in more than 72% similar to the rate as reported by Luhdorf, et al 10 in which there was seizure recurrence in more than 80% of elderly patients with a history of stroke. Status epilepticus de novo frequently occurs in the elderly with no prior history of epilepsy and represents a considerable risk for the subsequent development of epilepsy.…”

Section: Resultssupporting

confidence: 76%

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Gopi¹,

Chowdary²

2018

jebmh

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BACKGROUNDThe annual incidence is 85 per 1,00,000 for people aged 65-69 years and 135 per 1,00,000 for those aged over 80 years. Epilepsy in older patients poses several additional problems for the provision of services compared with the rest of the population as diagnostic difficulties and polypharmacy. The aim of the study is to-1. Know the various causes of seizures, clinical profile and correlation between neurological imaging and VEEG characteristics. 2. Know the differences between the aetiologies of seizures in young age and elderly >65 years.

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Section: Resultssupporting

confidence: 76%

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Gopi¹,

Chowdary²

2018

jebmh

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“…1 Epilepsy, defined as at least 2 unprovoked seizures occurring .24 hours apart, 2 is a common neurologic disorder in this age group. 3 While multiple studies have reported the prevalence and incidence of epilepsy in older adults, [4][5][6] their findings have limited generalizability. One recent study addressed the limited generalizability of prior studies by using outpatient administrative claims codes from the Centers for Medicare & Medicaid Services (CMS), which includes use data for .95% of the older adult US population.…”

mentioning

confidence: 99%

Predictors of incident epilepsy in older adults

et al. 2017

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Objective: To determine the prevalence, incidence, and predictors of epilepsy among older adults in the Cardiovascular Health Study (CHS). Methods:We analyzed data prospectively collected in CHS and merged with data from outpatient Medicare administrative claims. We identified cases with epilepsy using self-report, antiepileptic medication, hospitalization discharge ICD-9 codes, and outpatient Medicare ICD-9 codes. We used Cox proportional hazards regression to identify factors independently associated with incident epilepsy.Results: At baseline, 42% of the 5,888 participants were men and 84% were white. At enrollment, 3.7% (215 of 5,888) met the criteria for prevalent epilepsy. During 14 years of follow-up totaling 48,651 person-years, 120 participants met the criteria for incident epilepsy, yielding an incidence rate of 2.47 per 1,000 person-years. The period prevalence of epilepsy by the end of follow-up was 5.7% (335 of 5,888). Epilepsy incidence rates were significantly higher among blacks than nonblacks: 4.44 vs 2.17 per 1,000 person-years (p , 0.001). In multivariable analyses, risk of incident epilepsy was significantly higher among blacks compared to nonblacks (hazard ratio [HR] 4.04, 95% confidence interval [CI] 1.99-8.17), those 75 to 79 compared to those 65 to 69 years of age (HR 2.07, 95% CI 1.21-3.55), and those with history of stroke (HR 3.49, 95% CI 1.37-8.88).Conclusions: Epilepsy in older adults in the United States was common. Blacks, the very old, and those with history of stroke have a higher risk of incident epilepsy. The association with race remains unexplained. Neurology ® 2017;88:870-877 GLOSSARY CHF 5 congestive heart failure; CHS 5 Cardiovascular Health Study; CI 5 confidence interval; CMS 5 Centers for Medicare & Medicaid Services; HR 5 hazard ratio; ICD-9 5 International Classification of Diseases, ninth revision; TIA 5 transient ischemic attack.

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“…In Minnesota, 55% of all new cases of seizures in persons older than 65 were attributed to the acute or late effects of cerebrovascular disease [2,3]. Embolic strokes, intracerebral hemorrhages, and arteritis are the cerebrovascular diseases most often associated with seizures in this age-group [18,[31][32][33]. Seizures occur in 2.2-25% of patients with acute strokes [34][35][36][37], and in 3-8% of the cases as a chronic complication of strokes [37,38].…”

Section: Etiologymentioning

confidence: 99%

Changing Presentation of Seizures with Aging: Clinical and Etiological Factors

DeToledo

1999

Gerontology

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Background: The historically higher incidence of seizures in children has changed, the elderly now have a higher incidence than any age-group, 2–3 times of that found in children. Classical teachings on etiologies, clinical presentation and progression of seizures are based on observations of a younger population and need to be revised in view of features unique to this age-group. The findings of two large VA cooperative studies show that even in sophisticated medical environments, up to 30% of patients 60 years and older with recurrent partial seizures go undiagnosed for more than 1 year of seizure onset. Objective: (a) To characterize the manifestations of auras, seizures and postictal states in the elderly and the relevance of various etiologies to these presentations. (b) To identify and discuss factors that contribute to the difficulties in the diagnosis of seizures in this population. Methods: A review of our experience in treating a large population of elderly patients in a university epilepsy center and a review of the literature relating to the problem. Conclusions: Seizures in the elderly are both overdiagnosed and underdiagnosed: either situation can have serious adverse consequences. Diversity of etiologies and atypical presentations make recognition of seizures difficult. Histories are frequently inadequate: complaints of multiple physical symptoms confuse the picture, unwillingness of elderly patients to admit to problems they believe are physiological in nature by the fear others may think they are ‘losing their mind’ and high staff turnover result in erratic identification of problems. The significant morbidity and mortality associated with poorly controlled seizures in this population are in large part preventable since excellent response to treatment can be achieved in more than 80% of individuals. The correct diagnosis of seizures is more likely if both physician and patients are familiar with the nuances of epilepsy in the elderly.

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Epilepsy in the Elderly: Incidence, Social Function, and Disability

Cited by 89 publications

References 22 publications

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Profile and Short-Term Outcome in Adult Patients With New-Onset Seizures

Predictors of incident epilepsy in older adults

Changing Presentation of Seizures with Aging: Clinical and Etiological Factors

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