Mortality in older adults with epilepsy: An understudied entity
Syeda Amrah Hashmi1, Rithvik Gundlapalli2, Ifrah Zawar1
1Department of Neurology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Epilepsia Open
|November 11, 2024
Summary
Mortality in older adults with epilepsy is understudied, with unique risks like SUDEP, comorbidities, and polypharmacy contributing to premature death. Addressing these factors is crucial for improving outcomes in this population.
Area of Science:
- Neurology
- Geriatrics
- Public Health
Background:
- Mortality in older adults with epilepsy (PWE) is understudied despite recognition of risks like Sudden Unexpected Death in Epilepsy (SUDEP).
- Older adults have a heightened prevalence of epilepsy, influenced by intrinsic and extrinsic mortality factors.
- Diagnosing SUDEP in older adults is complex, with potential underestimation due to misclassification and lack of standardized protocols.
Purpose of the Study:
- To provide a comprehensive overview of premature mortality causes in older adults with epilepsy.
- To emphasize the need for targeted interventions to reduce mortality and improve quality of life in this population.
- To highlight the interplay of factors contributing to mortality in older PWE.
Main Methods:
- This is a review article, synthesizing existing literature on mortality in older adults with epilepsy.
- It examines factors including SUDEP, comorbidities (dementia, stroke, cardiovascular diseases), frailty, polypharmacy, and external causes.
- The review discusses diagnostic challenges and implications of anti-seizure medications.
Main Results:
- Mortality risks are compounded by frailty, comorbidities, and the bidirectional relationship between epilepsy and conditions like dementia and stroke.
- Key mortality factors include status epilepticus, cardiovascular diseases, cerebrovascular events, neurodegenerative disorders, accidents, falls, and suicide.
- Polypharmacy and its adverse effects significantly impact mortality in older PWE.
Conclusions:
- There is a critical need for enhanced diagnostic protocols and integrated treatment plans for older adults with epilepsy.
- Real-time monitoring technologies and increased awareness among healthcare providers and families are essential.
- Collaborative research efforts are vital to improve mortality outcomes and reduce premature death in this vulnerable group.
Related Concept Videos
01:24Arteries of the Lower Limbs
178
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
178
01:14Antiepileptic Drugs: Glutamate Antagonists
284
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
284
01:13Seizures: Classification
303
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
303
01:30Electroconvulsive Therapy
25
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
25