Abstract Details

Title Occurrence of cognitive impairment in older adult patients with epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P17 - Poster Session 17 (11:45 AM-12:45 PM)

Poster/Presentation
Number 10-001

Objective To demonstrate the clinical importance of screening cognitive impairment in older adult epilepsy patients.

Background Epilepsy and dementia have a bidirectional relationship of causation and chronology. Despite the clinical importance of this association, there are sparse data on the occurrence of cognitive impairment in older adult patients with epilepsy.

Design/Methods Participants aged ≥ 55 years without known diagnosis of neurocognitive disorder have been screened over two years (2019-2021) at the Older Adult Epilepsy Clinic. AD8 Dementia Screening Interview (AD8) and Rapid Cognitive Screening (RCS) were used as subjective and objective screening tools for cognitive impairment respectively. AD8 score ≥ 2 and RCS scores ≤ 7 (Mild Cognitive Impairment (MCI) 6-7; dementia ≤ 5) were considered as abnormal.

Results In total, 48 patients (mean age 63.8 years, female 50.0%) were included. Overall, 27 (56.3%) by AD8 and 33 (68.8%; RCS-based MCI 50.0%, dementia 18.8%) by RCS had cognitive impairment. Out of 27 patients with abnormal AD8, 22 (81.5%; RCS-based MCI 59.3% and dementia 22.2%) by RCS were cognitively impaired. Among 21 with normal AD8, 11 (52.4%; RCS-based MCI 38.1%, dementia 14.3%) by RCS showed abnormal screening results. Over the two-year follow-up, 4 patients have been diagnosed with MCI and 3 with dementia.

Conclusions Almost 60% of older adult epilepsy patients without a prior MCI/dementia diagnosis showed abnormalities in subjective screening test for cognitive impairment. Around 70% of patients had cognitive impairment on the objective test. Even though subjective screening was highly correlated with objective screening scores, half of patients who did not complain of subjective cognitive problems still showed abnormal findings in the objective screening test. Eventually, 15% of patients were diagnosed with neurocognitive disorder within 2 years. According to these findings, active emphasis should be placed on screening cognitive impairment in every older adult patient with epilepsy.

Authors/Disclosures
Jeongyeon Hwang, MD (Detroit Medical Center) PRESENTER	Dr. Hwang has nothing to disclose.
	No disclosure on file
Rohit A. Marawar, MD, FAAN (Wayne State University - Detroit Medical Center)	Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SK Pharma. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. Dr. Marawar has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis.

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