Abstract Details

Title Association Between Epilepsy Characteristics and Cognitive Impairment in Older Patients with Epilepsy

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-006

Objective

This study was aimed to explore the relationship between epilepsy characteristics and cognitive impairment in the older epilepsy patients.

Background

There has been emerging evidence implying the bidirectional relationship between epilepsy and dementia. However, there is limited evidence investigating the association between epilepsy characteristics and cognitive function in elderly population with epilepsy.

Design/Methods

Patients aged ≥ 55 years without known diagnosis of neurocognitive disorder were analyzed from the Geriatric Epilepsy Clinic over two years from 2019 to 2021. Alzheimer’s Disease – 8 (AD8) and Rapid Cognitive Screen (RCS) were used as subjective and objective screening tools for cognitive impairment respectively. AD8 score ≥ 2 and RCS score ≤ 7 were considered as positive. Logistic regression analyses were performed.

Results In a total of 56 older patients with epilepsy (mean age 63.95 years, female 51.80%, and African Americans 89.30%), 32 patients (57.10%) by AD8 and 36 patients (64.30%) by RCS had cognitive impairment. Among epilepsy characteristics, anti-epileptic drugs (AEDs) polytherapy, regardless of the number of AEDs, (β=2.151, p=0.037) and absence of generalized tonic-clonic seizures (GTCs) or focal to bilateral tonic-clonic seizures (FTBTCs; β=-2.010, p=0.032) showed significant associations with AD8 positivity after consideration of age, gender, education level, and history of anxiety, depression, and psychiatric disorders. Age of epilepsy onset, duration of epilepsy, seizure frequency, or etiology of epilepsy did not have any significant relationship with AD8. RCS positivity was not significantly associated with any epilepsy characteristics.

Conclusions

AEDs polytherapy and absence of GTCs/ FTBTCs in older epilepsy patients might predict subjective or caregiver-observed cognitive impairment. These results suggest that decreasing AEDs burden in this population needs to be considered in order to preserve cognitive function. Presentation of focal seizure without GTCs/ FTBTCs is sufficient to have cognitive impairment in the older epilepsy patients, who may require vigilant cognitive screening regardless of seizure types.

Authors/Disclosures
Jeongyeon Hwang, MD (Detroit Medical Center) PRESENTER	Dr. Hwang has nothing to disclose.
Konstantinos Avgerinos, MD (Detroit Medical Center/Wayne State University)	Dr. Avgerinos has nothing to disclose.
Sarah Tarbox-Berry	No disclosure on file
Scott Millis	Scott Millis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Taylor & Francis. The institution of Scott Millis has received research support from NIH & NIDILRR.
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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