ORLANDO, Fla. ― People with epilepsy experience earlier decline in memory function – especially if they have cardiovascular risk factors like high blood pressure or diabetes — than those without the condition, according to results of a large study presented at the American Epilepsy Society Annual Meeting.
The study is unique because it assesses the transition from healthy cognition to mild cognitive impairment (MCI) and MCI to dementia in people with and without epilepsy while also factoring in cardiovascular risk factors. People with MCI have clear symptoms showing changes in memory and thinking that do not significantly affect the person’s ability to carry out everyday activities. While some go on to develop dementia, others do not.
“While epilepsy itself is associated with MCI and dementia, this risk is substantially magnified in those who also have high blood pressure, diabetes or other cardiovascular risk factors,” said Ifrah Zawar, MD, lead author of the study and an assistant professor in the Department of Neurology at the University of Virginia, Charlottesville. “It is important to identify epilepsy promptly and treat it aggressively to help slow or prevent this decline in older adults who are cognitively healthy. In addition, early screening and targeted interventions towards modifiable cardiovascular risk factors may also help delay the onset of dementia.”
Researchers analyzed data from more than 13,700 cognitively healthy participants from 39 Alzheimer’s disease centers across the US who were part of the study between September 2005 and December 2021. Of those, fewer than 1 percent had epilepsy. Researchers determined that after accounting for age, sex, race, and education, those with epilepsy experienced a 65%-70% faster cognitive decline than those without epilepsy over the 14-year study period. Those with cardiovascular risk factors were more than 20% more likely to experience cognitive decline than those without cardiovascular risk factors, even after accounting for epilepsy.
However, the rate of decline from MCI to dementia was the same in patients with or without epilepsy. The researchers believe that’s likely because cardiovascular risk factors play a much bigger role than epilepsy in the later stages of dementia.