Prevalence of Dementia in a Level 4 Epilepsy Center: How Big Is the Problem?
Abstract number :
1.269
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2022
Submission ID :
2203922
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Christoph Helmstaedter, PhD – University Hospital Bonn, Department of Epileptology; Teresa Lutz, Statistics – Epileptology – University Hospital Bonn; Vinzent Wolf, data mining and extraction – Paris-Lodron Universität Salzburg; Juri-Alexander Witt, writing co-editing – Epileptology – Uiversity Hospital Bonn
Rationale: In the public and medical discourse, epilepsy has since long been associated with cognitive decline and dementia. Several underlying causes and risk factors have been identified to play a role in the relationship between epilepsy and cognition. Considering that “epileptic dementia” currently is a hot topic in epileptology, we raised the practical and clinical question of the prevalence of dementia diagnosed in patients seen at a level 4 epilepsy center.
Methods: A total of 145,501 letters of all 40,360 patients (>18 years) seen between 2003 and 2020 were screened for dementia terms via a key word search.
Results: Files of 513 extracted patients with at least one hit underwent in-depth inspection, according to which 12.7% respectively 6.6% of this group had or were suspected to have dementia, mild cognitive impairment was diagnosed in 4.9%, and 7% suffered from other neurodegenerative conditions. Referring to all patients seen in 17 years at our epilepsy center, this would indicate a prevalence of dementia of 0.25%. Within the selected group neither a longer duration of epilepsy, nor the epilepsy diagnosis, but an older age and a late-onset epilepsy appeared characteristic for the dementia diagnoses. An age and age of onset (> 60 yrs) increased the odds for (suspected) dementia diagnosis by 6.1 and 3.1. Besides this, vascular, metabolic, inflammatory, and mood related comorbidities were common features in those with a dementia diagnosis.
Conclusions: Patients of a level 4 epilepsy center are not representative for the general epilepsy population. Nevertheless, the results put the dementia issue in epilepsy into perspective. Epileptologists should be aware that dementias appear rare in epilepsy, that the risk is increased in the elderly, in late onset epilepsies and with comorbid risk factors for dementia, and that overall there is no need for excessive patient concerns.
Funding: None
Cormorbidity (Somatic and Psychiatric)