Effect Modification of Alcohol Use on Epilepsy: NHIS Longitudinal Study

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Alcohol's complex relationship with epilepsy includes lowering seizure thresholds and potential epileptogenesis.
• Chronic alcohol misuse can lead to neuronal injury and neurotransmitter dysregulation.
• The long-term mortality impact of alcohol use in people with epilepsy (PWE) is not well understood.

Purpose of the Study:

• To evaluate all-cause mortality risk in individuals with epilepsy based on alcohol consumption.
• To stratify mortality risk by race/ethnicity in the context of epilepsy and alcohol use.

Main Methods:

• Utilized data from the 2008-2018 National Health Interview Survey (NHIS) linked to the National Death Index (NDI).
• Included U.S. adults aged 18+; PWE and alcohol use determined via self-report.
• Employed Kaplan-Meier survival analysis and adjusted Cox proportional hazards models.

Main Results:

• Alcohol use among PWE was linked to increased all-cause mortality (adjusted HR=1.40).
• Alcohol use without epilepsy did not show elevated mortality risk after adjustment.
• The epilepsy-alcohol combination significantly increased mortality in Black individuals, but not White individuals.

Conclusions:

• Combined epilepsy and alcohol use is associated with higher all-cause mortality than alcohol use alone.
• Observed racial disparities in mortality risk necessitate further investigation.
• Integrated clinical care and research into genetic, biological, and social determinants are crucial for improving epilepsy outcomes.