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A bidirectional association between cognitive ability in young adulthood and epilepsy: a population-based cohort
Merete Osler1,2,3, Erik L Mortensen2,3,4, Kaare Christensen3,5
1Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark.
International Journal of Epidemiology
|February 17, 2018
Summary
Lower cognitive ability in young adulthood is linked to an increased risk of developing epilepsy later in life. This association suggests that cognitive function may be a factor in epilepsy development.
Area of Science:
- Neuroscience
- Epidemiology
- Cognitive Science
Background:
- Epilepsy is a chronic neurological disorder affecting millions worldwide.
- Understanding the relationship between cognitive function and epilepsy is crucial for early detection and intervention.
- Previous research has suggested a link between cognitive impairment and epilepsy, but the directionality and strength of this association require further investigation.
Purpose of the Study:
- To investigate the bidirectional association between cognitive ability in young adulthood and the subsequent risk of developing epilepsy.
- To determine if lower cognitive function predicts a higher risk of epilepsy.
- To explore the cognitive status of individuals with pre-existing epilepsy.
Main Methods:
- A large-scale cohort study utilizing Danish national registries, including over 1.1 million men and supplementary female volunteers.
- Cognitive ability was assessed at conscription (around age 19).
- Epilepsy diagnoses were identified using International Classification of Diseases (ICD) codes from 1977 to 2016, with follow-up until ages 40 and 60.
Main Results:
- Men diagnosed with epilepsy before conscription exhibited significantly lower cognitive scores (0.25 SD lower).
- A total of 22,364 individuals developed epilepsy, with cognitive ability inversely associated with epilepsy risk (HR per SD increase = 0.75 at age 40).
- The association between lower cognition and epilepsy risk attenuated with increasing age at diagnosis, and findings were consistent in female conscripts.
Conclusions:
- Cognitive impairment observed in adults with epilepsy appears to result from a combination of epileptic processes and lower premorbid cognitive ability.
- This study highlights the predictive value of cognitive function for epilepsy risk.
- The findings underscore the importance of considering cognitive status in the context of epilepsy etiology and progression.
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