Authors :
Presenting Author: Daniel Guerrero Gutierrez, BS Candidate – Brigham Young University
Sofia Pelagalli Maia, BS Candidate – Brigham Young University
Hyunmi Choi, MD, MS – Columbia University
Jose Gutierrez, MD, MPH – Columbia University
Natalie Bello, MD, MPH – Cedars Sinai Medical Center
Mary Lou Biggs, PhD – University of Washington
Emily M. Briceño, PHD – University of Michigan
Lisandro D. Colantonio, MD, PHD – University of Alabama at Birmingham
Mitchell S.V. Elkind, MD, MS – Columbia University, American Heart Association
Annette L. Fitzpatrick, PHD – University of Washington
Christopher Gonzalez, MS – Rosalind Franklin University of Medicine and Science
Alden L. Gross, PhD – Johns Hopkins University
Lei Huang, PhD – University of Alabama at Birmingham
Emily L. Johnson, MD, MPH – Johns Hopkins University
W. Craig Johnson, MS – University of Washington
Cheng-Shiun Leu, PhD – University of Michigan
Deborah A. Levine, MD – University of Michigan
Minghua Liu, PhD – Columbia University
W.T. Longstreth Jr, MD – University of Washington
Richard P. Mayeux, MD, MSc – Columbia University
Sylwia Misiewicz, MA, MEd – Columbia University
Dolly Reyes-Dumeyer, BS – Columbia University
Tatjana Rundek, MD, PhD – University of Miami
Danurys Sanchez, MS – Columbia University
Steven J. Shea, MD, MS – Columbia University
Tian Wang, PhD – Columbia University
Carolyn W. Zhu, PhD – Mount Sinai School of Medicine
Evan L. Thacker, PhD – Brigham Young University
Rationale:
Epilepsy in late life is associated with biological, behavioral, social, and environmental factors. However, the association of lifetime occupation type with late-life epilepsy remains understudied. Occupation type encompasses long-term socioeconomic, environmental, and physical exposures that may influence brain health in late life. We analyzed pooled data from four large, NIH-funded, community-based cohorts to examine the association of longest-held occupation type with incidence and prevalence of epilepsy in older adults.
Methods:
Participants were from ARIC, CHS, NOMAS, and WHICAP. Age, sex, race/ethnicity, level of education, and longest-held occupation type at baseline were self-reported. We classified the longest-held occupation type as white collar, blue collar, or homemaker. In ARIC, CHS, and WHICAP, we included only those participants who had at least 2 years of continuous Medicare enrollment and were ≥65 years of age, ascertaining epilepsy via a validated algorithm applied to ICD-9/ICD-10 codes appearing in Medicare claims. In NOMAS, which was not Medicare-linked, we included participants who were ≥40 years of age, ascertaining epilepsy via self-report followed by medical record review. Incident epilepsy was new-onset epilepsy during follow-up, while prevalent epilepsy was identified at baseline. We used multivariable regression models to estimate incidence rate differences, incidence rate ratios, prevalence differences, and prevalence ratios, comparing occupation types, adjusted for cohort, age, sex, race/ethnicity, and attained education.
Results:
Among 21,488 participants at baseline, 228 had prevalent epilepsy. Among 20,873 participants followed for a mean of 10.8 years, 724 developed incident epilepsy. Participants had a mean age of 72 years, 60% were female, 36% were of minority racial/ethnic groups, and 42% had education beyond high school. Unadjusted incidence rates were 3.1 per 1,000 person-years (PY) among white collar workers, 3.5 per 1,000 PY among blue collar workers, and 2.8 per 1,000 PY among homemakers (Table 1). Fully-adjusted incidence rate ratios, compared to white collar workers, were 0.99 (95% CI: 0.81, 1.21; P = 0.93) for blue collar workers and 1.02 (95% CI: 0.81, 1.30; P = 0.84) for homemakers. Unadjusted prevalences were 9.9 per 1,000 white collar workers, 12.3 per 1,000 blue collar workers, and 8.7 per 1,000 homemakers (Table 2). Fully-adjusted prevalence ratios, compared to white collar workers, were 0.77 (95% CI: 0.53, 1.11; P = 0.16) for blue collar workers and 0.89 (95% CI: 0.56, 1.39; P = 0.63) for homemakers.
Conclusions:
Self-reported longest-held occupation type, defined as white collar, blue collar, or homemaker, was not significantly associated with incidence or prevalence of epilepsy in late life in this pooled cohort study. Future work on more detailed occupation types may clarify whether work-related exposures influence epilepsy risk in late life.
Funding: N/A