Depressive Symptoms and Quality of Life in Older Adults with Epilepsy: A Multi-Study Analysis from the Managing Epilepsy Well (MEW) Network
Abstract number :
1.126
Submission category :
17. Public Health
Year :
2025
Submission ID :
234
Source :
www.aesnet.org
Presentation date :
12/6/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Farren Briggs, PhD – University of Miami
Elaine Kiriakopoulos, MD, MPH, MSc – Dartmouth Health
Nicole Fiorelli, MA – Case Western Reserve University
Robin McGee, PhD – Emory University
Erica Johnson, PhD – University of Washington
Barbara Jobst, MD, Dr. MED, FAES, FAAN – Dartmouth Health
Cam Escoffery, PhD, MPH – Emory University
Ross Shegog, PhD – UTHealth Houston School of Public Health
Refugio Sepulveda, PhD – University of Arizona
Tanya Sprulli, PhD – NYU Grossman School of Medicine
MARTHA SAJATOVIC, MD – Case Western Reserve University
Rationale: From 2010 to 2020, the U.S. population aged 65+ experienced its fastest growth rate, 38.6% from 40.3 mil to 55.8 mil. It is expected that these demographic changes will drive the number of older individuals developing epilepsy to increase significantly. Globally, in high-income countries, the incidence of epilepsy is already highest for individuals age 65+. In the U.S., about one million people with active epilepsy are adults aged 55+. Older adults with epilepsy (OAWE) experience complex health conditions that compromise quality of life (QOL). Depressive symptoms have a pronounced impact on QOL among people with epilepsy across the lifespan, often exceeding that of seizure control. However, the relative contribution of depressive symptom dimensions to health-related QOL remains unexplored in the OAWE population. This study aims to address this research gap in OAWE by analyzing aggregate data from the Managing Epilepsy Well Network Integrated Database (MEW-DB).
Methods: We analyzed baseline data from 13 epilepsy self-management studies in the CDC-sponsored MEW-DB, including adults aged 55 and older (N=198). The primary outcome was health-related QOL, assessed via the 10-item Quality of Life in Epilepsy scale (QOLIE-10), inverse rank normalized to meet model assumptions. Primary predictors included the Patient Health Questionnaire (PHQ-9) total score, cognitive and somatic symptom sub scores, and suicide ideation. Multivariable mixed-effects linear regression assessed associations, adjusting for age, sex, race, ethnicity, education, epilepsy duration, seizure type, income, employment status, and seizure occurrence in the prior 30 days. Models included a random intercept for originating study.
Results: Participants were x̄ = 60.8 years (range: 55-79); 60.6% female and 68.7% white. On average, participants had mild depressive symptoms (PHQ-9 = 8.3). Depressive symptom severity was significantly associated with worse QOL. Cognitive (ß=0.17, 95% CI: 0.12-0.21, p=5.6x10-13), somatic (ß=0.19, 95% CI: 0.14-0.23, p=3.3x10-17), and total depressive (PHQ-9 total) symptoms (ß=0.10, 95% CI: 0.08-0.12, p=3.8x10-21) were associated with worse QOLIE-10 scores when adjusting for likely confounders. Suicide ideation was not associated with QOLIE-10 (ß=0.07, 95% CI: -0.15 to 0.29, p=0.51). Past 30-day seizure occurrence was associated with worse QOLIE-10 only when depressive terms were excluded from the multivariable model (ß=0.38, 95% CI: 0.05-0.72m, p=0.024).
Conclusions: Among OAWE, depressive symptoms - particularly cognitive and somatic components - are strongly linked to reduced QOL. While recent seizure activity also contributes to QOL, though depressive symptoms appear to explain a greater proportion of variance, highlighting the impactful role of mood in this understudied older adult population. These findings underscore the importance of integrated mental health screening and intervention for OAWE.
Funding: None
Public Health