Tracking psychosocial health in adults with epilepsy—Estimates from the 2010 National Health Interview Survey

Kobau, Rosemarie; Cui, Wanjun; Kadima, N.; Zack, Matthew M.; Sajatovic, Martha; Kaiboriboon, Kitti; Jobst, Barbara C.

doi:10.1016/j.yebeh.2014.08.002

Cited by 53 publications

(42 citation statements)

References 34 publications

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“…Our analysis confirms earlier findings [22] that psychological distress is substantially more prevalent among adults with active epilepsy, making their greater need for mental health services evident. The findings from this survey indicate not only that adults with active epilepsy use more mental health services than adults without epilepsy but also that significant numbers are unable to afford or find access to sufficient services.…”

Section: Discussionsupporting

confidence: 91%

Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013

Thurman

Kobau

Luo

et al. 2016

Epilepsy & Behavior

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Introduction Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care. Materials and methods We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity. Results Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR = 3.58) and less likely to have private health insurance (RR = 0.58). Adults with active epilepsy were also less likely to be employed (RR = 0.53) and much more likely to report being disabled (RR = 6.14). They experience greater barriers to health-care access including an inability to afford medication (RR = 2.40), mental health care (RR = 3.23), eyeglasses (RR = 2.36), or dental care (RR = 1.98) and are more likely to report transportation as a barrier to health care (RR = 5.28). Conclusions These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention.

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Section: Discussionsupporting

confidence: 91%

Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013

Thurman

Kobau

Luo

et al. 2016

Epilepsy & Behavior

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“…17,19 This study has several limitations that should be acknowledged including the modest sample size, limited but pertinent scope of risk factors, cross-sectional research design, and circumscribed knowledge of lifetime AED use and compliance. 17,19 This study has several limitations that should be acknowledged including the modest sample size, limited but pertinent scope of risk factors, cross-sectional research design, and circumscribed knowledge of lifetime AED use and compliance.…”

Section: Discussionmentioning

confidence: 99%

Vascular, inflammatory, and metabolic factors associated with cognition in aging persons with chronic epilepsy

Hermann

Sager²,

Koscik³

et al. 2017

Epilepsia

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We examined cognition in aging persons with chronic epilepsy; characterized targeted vascular, inflammatory, and metabolic risk factors associated with abnormal cognitive aging in the general population; and examined associations between cognition and vascular, inflammatory, and metabolic health. Participants included 40 persons with chronic localization-related epilepsy and 152 controls, aged 54.6 and 55.3, respectively. Participants underwent neuropsychological assessment, clinical examination, and fasting blood evaluation for quantification of vascular status (systolic and diastolic blood pressure, obesity/body mass index [BMI], total and high-density lipoprotein [HDL] cholesterol level, and homocysteine), inflammatory markers (high sensitivity C-reactive protein [hs-CRP], and interleukin-6 [IL-6]), and metabolic status (insulin resistance [Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)], glucose). Epilepsy participants exhibited impairment across all cognitive factor scores (all p's < 0.0001); abnormalities in BMI (p = 0.049), hs-CRP (p = 0.046), HOMA-IR (p = 0.0040), and fasting glucose (p = 0.03), with significant relationships between higher HOMA-IR with poorer Immediate Memory (p = 0.03) and Visuospatial Ability (0.03); elevated hs-CRP with poorer Visuospatial (p = 0.035) and Verbal Ability (p = 0.06); elevated BMI with poorer Speed/Flexibility (p = 0.04), Visuospatial (p = 0.001) and Verbal Ability (p = 0.02); and lower HDL with poorer Verbal Learning/Delayed Memory (p = 0.01), Speed/Flexibility (p = 0.043), and Working Memory (p = 0.008). Aging persons with chronic epilepsy exhibit multiple abnormalities in metabolic, inflammatory, and vascular health that are associated with poorer cognitive function.

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“…Quality of Life (QOL) is often impaired among individuals with epilepsy [11] for a variety of reasons including complications due to seizures and having a chronic health condition, stigma and social isolation. In this analysis, using baseline data from the MEW DB, correlates of quality of life (QOL) in people with epilepsy were analyzed in relation to selected standardized demographic and clinical variables available across epilepsy self-management research studies.…”

Section: Introductionmentioning

confidence: 99%

Correlates of quality of life among individuals with epilepsy enrolled in self-management research

Sajatovic

Tatsuoka

Welter

et al. 2017

Epilepsy & Behavior

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Rationale: Epilepsy is a chronic neurological condition that causes substantial burden on patients and families. Quality of life may be reduced due to the stress of coping with epilepsy. For nearly a decade, the Centers for Disease Control (CDC) Prevention Research Center’s Managing Epilepsy Well (MEW) Network has been conducting research on epilepsy self-management to address research and practice gaps. Studies have been conducted by independent centers across the U.S. Recently, the MEW Network sites, collaboratively, began compiling an integrated database to facilitate aggregate secondary analysis of completed and ongoing studies. In this preliminary analysis, correlates of quality of life in people with epilepsy (PWE) were analyzed from pooled baseline data from the MEW Network. Methods: For this analysis, data originated from 6 epilepsy studies conducted across 4 research sites and comprised 459 PWE. Descriptive comparisons assessed common data elements that included gender, age, ethnicity, race, education, employment, income, seizure frequency, quality of life, and depression. Standardized rating scales were used for quality of life (QOLIE-10) and for depression (Patient Health Questionnaire, PHQ-9). Results: While not all datasets included all common data elements, baseline descriptive analysis found a mean age of 42 (SD 13.22), 289 women (63.0%), 59 African Americans (13.7%), 58 Hispanics (18.5%). Most, 422 (92.8%), completed at least high school, while 169 (61.7%) were unmarried, divorced/separated, or widowed. Median 30-day seizure frequency was 0.71 (range 0-308). Depression at baseline was common, with a mean PHQ-9 score of 8.32 (SD 6.04); 69 (29.0%) had depression in the mild range (PHQ-9 score 5-9) and 92 (38.7%) had depression in the moderate to severe range (PHQ-9 score > 9). Lower baseline quality of life was associated with greater depressive severity (p <.001), more frequent seizures (p<.04) and lower income (p<.05). Conclusions: The MEW Network integrated database offers a unique opportunity for secondary analysis of data from multiple community-based epilepsy research studies. While findings must be tempered by potential sample bias, i.e. a relative under-representation of men and relatively small sample of some racial/ethnic subgroups, results of analyses derived from this first integrated epilepsy self-management database have potential to be useful to the field. Associations between depression severity and lower QOL in PWE are consistent with previous studies derived from clinical samples. Self-management efforts that focus on mental health comorbidity and seizure control may be one way to address modifiable factors that affect quality of life in PWE.

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Tracking psychosocial health in adults with epilepsy—Estimates from the 2010 National Health Interview Survey

Abstract: Objective-This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey.

Cited by 53 publications

References 34 publications

Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013

Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013

Vascular, inflammatory, and metabolic factors associated with cognition in aging persons with chronic epilepsy

Correlates of quality of life among individuals with epilepsy enrolled in self-management research

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