Abstracts

It has become important to understand the potential cognitive problems that older adults with epilepsy might encounter. We previously demonstrated cognitive impairments in epilepsy seniors. To further investigate potential cognitive declines in epilepsy seniors, we conducted a prospective study of cognitive performance across a three-year time span. Fifteen epilepsy seniors averaging 68 years of age (range 62-77) at follow-up were studied. Participants had partial-onset seizures for 34 years on average. All participants completed measures of overall cognition, attention, language, memory, construction, abstraction, executive function, and mood at baseline and at an average follow-up interval of 3.1 years. Epilepsy seniors showed worsening executive control over the follow-up period as measured by the Executive Interview Test (EXIT), t(13)=-3.06, p=.009. A trend towards significance was observed for poorer performance on WMS-III Logical Memory I (p = .06). There were no other changes observed in neuropsychological test performance or mood across the follow-up interval (all p values [gt] .10). Across three years, epilepsy seniors had diminished executive control with some evidence of decreased verbal recall. Otherwise, stability in cognitive functioning was observed. Older adults with epilepsy appear prone to selective worsening of executive control. Numerous factors could contribute to executive dyscontrol, including brain atrophy related to continued seizures and/or cognitive effects of medications due to age-related changes in pharmacokinetics. Further study is necessary to determine what factors contribute to worsening executive dyscontrol in epilepsy seniors.[table1] (Supported by Epilepsy Foundation of America and Centers for Disease Control.)