Epilepsy as a predictor of subjective memory and executive dysfunction in American children and adults, with sleep as...

People with epilepsy (PWE), including adults with epilepsy (AWE) and children with epilepsy (CWE), may experience problems with attention and memory. We hypothesized that epilepsy and sleep disturbances are associated with subjective memory and executive dysfunction. Using cross-sectional investigation of two nationally-representative U.S. surveys, the 2021-2023 National Health Interview Survey (NHIS) and the 2016-2023 National Survey of Children's Health (NSCH), we tested if subjective concentration or memory difficulty differed between children or adults with (n = 2675 children; n = 1570 adults) and without (n = 217,579 children; n = 84,763 adults) epilepsy. Analyses examined epilepsy (comparisons of no epilepsy, inactive epilepsy, and active epilepsy) as a predictor of memory, concentration, or decision-making difficulties. Data were analyzed in survey-weighted adjusted logistic regression models. Exploratory analyses evaluated seizure frequency, sleep health, physical activity, depression, and anxiety, as well as socialization in children. CWE had > 7 times higher odds of subjective memory, concentration, or decision-making difficulty compared to children without epilepsy (OR_adj = 7.3; 95%CI: 6.21, 8.56; p < 0.001), and AWE had > 3.5 times higher odds of memory or concentration difficulty compared to people without epilepsy (OR_adj = 3.7; 95%CI: 3.2, 4.2; p < 0.001). Odds were higher for PWE with active epilepsy. Reported memory or concentration difficulty were associated with worse sleep health in both AWE and CWE (p < 0.05). This large epidemiological study evaluated the prevalence of memory and executive dysfunction among 4,245 PWE, highlighting the ubiquity of memory and attention complaints, regardless of age or disease status. Memory and attention difficulties, particularly among CWE, may be an important factor in epilepsy-related disparities.