Exploring the relationship between everyday functioning and cognitive performance in individuals with late onset...

Area of Science:

• Neurology
• Geriatrics
• Epilepsy Research

Background:

• Late onset unexplained epilepsy (LOUE) is associated with cognitive and functional decline.
• Determinants of functional impairment in LOUE are not fully understood.
• The Functional Activities Questionnaire (FAQ) is a potential tool for assessing functional status.

Purpose of the Study:

• To evaluate the Functional Activities Questionnaire (FAQ) in adults with LOUE.
• To examine the association between functional impairment and cognitive/epilepsy-related factors in LOUE.

Main Methods:

• Cross-sectional study of 82 adults with LOUE (seizure onset >55 years).
• Functional impairment assessed using the FAQ (score ≥6).
• Cognitive function, including delayed verbal recall, was evaluated.
• Firth penalized logistic regression identified predictors of functional impairment.

Main Results:

• 12.2% of participants experienced functional impairment.
• Functionally impaired individuals had worse cognitive performance and higher antiseizure medication (ASM) burden.
• Increased ASM number and lower delayed verbal recall z-scores predicted functional impairment.
• Memory-related cognitive tasks were most affected.

Conclusions:

• Functional impairment in LOUE correlates with poorer cognition and greater ASM burden.
• The FAQ is a practical screening tool for functional impairment in LOUE.
• Minimizing medication burden is crucial for managing functional decline in this population.