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Epilepsy in elderly patients: does age of onset make a difference?
A Suller Marti1, E Bellosta Diago2, P Vinueza Buitron2
1Programa de Epilepsia, Departamento de Ciencias Neurológicas, Schulich School of Medicine, Western University, London, Ontario, Canada.
Elderly-onset epilepsy, diagnosed at age 65 or older, is frequently linked to vascular causes and cardiovascular risk factors. These patients often require lower doses and fewer antiepileptic drugs compared to younger individuals.
Area of Science:
- Neurology
- Geriatrics
- Epidemiology
Background:
- Epilepsy prevalence increases with age due to population aging.
- Epilepsy presentation and management differ significantly in older adults.
Purpose of the Study:
- To compare epilepsy characteristics and comorbidities in patients aged 65+ diagnosed before and after this age.
- To identify factors associated with late-onset epilepsy.
Main Methods:
- Retrospective, observational study of 123 epilepsy patients.
- Comparison of two groups: epilepsy diagnosed before age 65 (Group A) and at/after age 65 (Group B).
Main Results:
- Late-onset epilepsy (Group B) showed a higher prevalence of vascular etiology (74.2%) and stroke history (51.6%) compared to Group A.
- Group B patients required lower doses and fewer antiepileptic drugs.
- Significant differences observed in cognitive impairment, psychiatric disorders, and diabetes mellitus between groups.
Conclusions:
- Epilepsy onset at age 65+ is strongly associated with cardiovascular risk factors.
- Older adults with epilepsy may benefit from adjusted antiepileptic drug regimens.
- Status epilepticus can be an initial presentation in some elderly epilepsy cases.
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