New research has drawn attention to the high risk of cognitive impairment that exists among older people with epilepsy.
Conducted by Brown University and Rhode Island Hospital, the study sought to improve our understanding of mental functioning among older people with epilepsy and identify potential risk factors for cognitive problems.
It is well understood that cognitive impairment is a common issue for individuals with epilepsy, but to date the amount of research into the way this specifically affects older people has been limited.
During the current study, 67 people aged 55 years and over – 38 with epilepsy, 29 without – undertook a series of neuropsychological tests, along with assessments for depression and anxiety. The results obtained from each group were later compared. The people in the epilepsy group also underwent a medication and seizure history review, and brain imaging.
The findings, published in Epilepsy & Behavior, showed that, compared to the non-epilepsy (control) group, those with epilepsy performed worse across nearly all measures of cognitive performance. They also had higher levels of depression and anxiety, which supports previous findings.
Interestingly, the results indicated that people with epilepsy were more likely to be diagnosed as clinically impaired on individual tests, even if they had no obvious abnormalities on brain imaging. According to the researchers, this may suggest that epilepsy interacts with the aging process, or with other medical conditions associated with aging, to increase the risk of cognitive decline.
For all people with epilepsy, taking a larger number of antiepileptic drugs was found to be linked to poorer language and visuospatial abilities, and those who experienced higher levels of anxiety generally had poorer visual memories.
The paper concludes: ‘Polytherapy (taking a combination of antiepileptic drugs) and anxiety heightened the risk for cognitive impairment in some cognitive domains, but not in others.
Understanding the nature of cognitive decline in this population, as well as associated risk factors, may assist in the differential diagnosis of cognitive complaints and improve the design of treatment studies for older patients with epilepsy.’
The authors add that larger studies should now be conducted to get a better a clearer picture of the risks that older people with epilepsy face with regard to their cognitive functioning.
Click here for more articles about conditions related to epilepsy.