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Clinical Manifestations.

Ifrah Zawar1, Jaideep Kapur1, Meghan K Mattos1

  • 1University of Virginia, Charlottesville, VA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Active seizures significantly impair Instrumental Activities of Daily Living (IADL) in older adults, regardless of cognitive status. This decline is faster in those with active seizures, highlighting the need for IADL assessment and seizure management.

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Area of Science:

  • Gerontology
  • Neurology
  • Public Health

Background:

  • Cognitive deficits are prevalent in older persons with seizures (PWS), often impacting Instrumental Activities of Daily Living (IADL).
  • The specific effects of active versus remote seizures on IADL impairment and decline in older PWS remain under-explored.
  • This study investigates the relationship between seizure status and IADL function in older adults, considering cognitive status.

Purpose of the Study:

  • To examine the association between active and remote seizures and baseline IADL impairment in older adults.
  • To investigate the longitudinal decline of IADLs in older adults with and without cognitive impairment based on seizure status.
  • To determine if active seizures disproportionately affect IADL performance compared to cognitive abilities.

Main Methods:

  • A prospective study involving 20,486 cognitively normal and 30,238 cognitively impaired participants across 42 US Alzheimer's Disease Research Centers.
  • Participants were categorized into active seizures, remote seizures, and no seizures (controls).
  • Instrumental Activities of Daily Living (IADL) were assessed using the Pfeffer Functional Activities Questionnaire (FAQ), with statistical analyses including ANOVA and multivariable linear regression.

Main Results:

  • Active seizures were associated with significantly worse baseline IADL performance in both cognitively normal and impaired older adults compared to remote seizures or controls.
  • Cognitively normal individuals with active seizures exhibited a faster longitudinal decline in IADLs compared to controls.
  • Impairment in IADLs for active seizure participants was disproportionately higher than their cognitive status suggested, particularly in managing finances and daily tasks.

Conclusions:

  • Active seizures are linked to poorer IADL performance and accelerated IADL decline in older adults, irrespective of cognitive status.
  • The findings underscore the importance of routine IADL assessment in older PWS to identify needs for assistance.
  • Aggressive seizure management is recommended to help preserve independence in older individuals with active seizures.