Racial/ethnic Differences in the Association of Incident Stroke with Late Onset Epilepsy: The Northern Manhattan Study
Abstract number :
2.071
Submission category :
16. Epidemiology
Year :
2024
Submission ID :
1220
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Hyunmi Choi, MD, MS – Columbia University Medical Center
Evan Thacker, PhD – Brigham Young University
Minghua Liu, PhD – Columbia University
Kevin Strobino, MPH – Weill Cornell Medicine
Sylwia Misiewicz, MA, MEd – Columbia University
Tatjana Rundek, MD, PhD – University of Miami
Mitchell Elkind, MD, MS, MPhil – Columbia University, America Heart Association
Jose Gutierrez, MD, MPH – Columbia University
Rationale: Little is known about the incidence of late-onset epilepsy (LOE) across different racial and ethnic groups in the US, particularly in the Hispanic population. Stroke, a strong predictor of LOE, is more common in non-Hispanic Black and Hispanic individuals than in non-Hispanic White individuals. We assessed the incidence of LOE across racial/ethnic groups and examined whether the associations of stroke and other vascular risk factors with LOE risk differ by race/ethnicity.
Methods: The Northern Manhattan Study (NOMAS) is a population-based longitudinal cohort study of older adults enrolled in Northern Manhattan between 1993 and 2001. Participants who were free of history of stroke or epilepsy at baseline (n = 3,419) were followed prospectively for a median of 15.2 years for incidence of LOE. We estimated unadjusted and age-adjusted LOE incidence rates per 1,000 person-years in each racial/ethnic group. We then used Cox proportional hazards regression to assess the association of race/ethnicity with LOE, adjusting for demographics, health behaviors, and comorbid diagnoses. We then added interactions to the Cox model on a multiplicative scale between race/ethnicity and incident stroke with LOE.
Results: During 51,176 person-years of follow-up, 183 individuals developed LOE. Incidence of LOE was significantly higher in non-Hispanic Black individuals (6.2 per 1000 person-years) than in non-Hispanic White individuals (3.3 per 1000 person-years) [p=0.004] (Table 1). There was no significant difference in LOE incidence between non-Hispanic White (3.3 per 1000 person-years) and Hispanic individuals (2.6 per 1000 person-years) [p=0.875]. However, following incident stroke, the risk of LOE differed across racial/ethnic groups (Table 2). Incident stroke was associated with 2.55 times the risk of LOE among non-Hispanic White individuals (95% CI 0.88, 7.35), 8.53 times the risk of LOE among Hispanic individuals (95% CI 5.36, 13.57; p = 0.04 for stronger association than that in non-Hispanic White individuals), and 6.46 times the risk of incident epilepsy among non-Hispanic Black individuals (95% CI 3.79, 11.01; p = 0.12 for stronger association than that in non-Hispanic White individuals).
Conclusions: We found a stronger association of incident stroke with LOE risk in Hispanic and non-Hispanic Black individuals than in non-Hispanic White individuals, offering some insight into the racial/ethnic disparities of LOE incidence.
Funding: This work was supported by the National Institute of health (grants R01AG074355, R01AG057709, R01AG066162, R56NS029993). Drs. Choi, Thacker, and Gutierrez were supported by the National Institute of Aging (R01AG074355). Drs. Elkind, Rundek, and Gutierrez were supported by the National Institute of Neurological Disorders and Stroke (R01AG057709, R01AG066162, R56NS029993).
Epidemiology