Seizures in patients with Alzheimer’s disease or vascular dementia: A population‐based nested case–control analysis

Abstract

SUMMARYPurpose: Patients with Alzheimer's disease (AD) have an increased risk of developing seizures or epilepsy. Little is known about the role of risk factors and about the risk of developing seizures/epilepsy in patients with vascular dementia (VD). The aim of this study was to assess incidence rates (IRs) of seizures/epilepsy in patients with AD, VD, or without dementia, and to identify potential risk factors of seizures or epilepsy. Methods: We conducted a follow-up study with a nested case-control analysis using the United Kingdom-based General Practice Research Database (GPRD). We identified patients aged ‡65 years with an incident diagnosis of AD or VD between 1998 and 2008 and a matched comparison group of dementia-free patients. Conditional logistic regression was used to estimate the odds ratio (OR) with a 95% confidence interval (CI) of developing seizures/ epilepsy in patients with AD or VD, stratified by age at onset and duration of dementia as well as by use of antidementia drugs. Key Findings: Among 7,086 cases with AD, 4,438 with VD, and 11,524 matched dementia-free patients, we identified 180 cases with an incident diagnosis of seizures/epilepsy. The IRs of epilepsy/seizures for patients with AD or VD were 5.6/1,000 person-years (py) (95% CI 4.6-6.9) and 7.5/ 1,000 py (95% CI 5.7-9.7), respectively, and 0.8/1,000 py (95% CI 0.6-1.1) in the dementia-free group. In the nested case-control analysis, patients with longer standing ( ‡3 years) AD had a slightly higher risk of developing seizures or epilepsy than those with a shorter disease duration, whereas in patients with VD the contrary was observed. Significance: Seizures or epilepsy were substantially more common in patients with AD and VD than in dementiafree patients. The role of disease duration as a risk factor for seizures/epilepsy seems to differ between AD and VD.

Human symptoms–disease network

“…In the HSDN, AD shows high symptom similarity with epilepsy and several of its variants, like temporal lobe epilepsy (0.63). The two diseases also exhibit significant comorbidity 51 . An antiepileptic drug (levetiracetam) was recently found to reverse deficits in learning and memory in AD mice and might also help ameliorate related abnormalities in human 52 .…”

Hippocampal Sclerosis and Epilepsy in Elderly Population

“…Furthermore, the incidence has been shown to increase with age in the Nordic population [21][22][23]. The reported prevalence of EP in dementia and AD varied from 5% to 64% [24][25][26][27][28][29][30][31][32][33][34]. When all cognitively unimpaired subjects with HS were lumped together here, three out of 23 (11%) had displayed EP during life, thus indicating a high frequency, when compared to the general population.…”

Epilepsy in elderly patients

“…Demans hastaları arasında epilepsi prevalansı normal topluma göre altı-sekiz kat daha yüksektir. [10] Demans tipleri arasında Alzhemier demansı epilepsi prevalansı en yüksek grubu oluşturmaktadır. [11] Hastalık süresinin üç yıl ve üzerinde olması ve ciddi kognitif etkilenme nöbet gelişim riskini artırmaktadır.…”

“…[11] Hastalık süresinin üç yıl ve üzerinde olması ve ciddi kognitif etkilenme nöbet gelişim riskini artırmaktadır. [9][10][11] …”