Abstracts

Rationale: Individuals with seizures have been reported to be at higher risk for Alzheimer’s disease compared to the general population. People with Alzheimer’s disease are thought to be at higher risk for seizures. The prevalence of epilepsy in individuals with Alzheimer’s disease ranges from 0.5% to 64% (Horvath et al., 2016). Baker et al (2019) studied a sample of patients recruited from a memory clinic network diagnosed with mild cognitive impairment or Alzheimer’s disease and reported possible or probable seizures in 27%. The current study screened all patients who were evaluated in a university geriatric memory clinic to identify the point prevalence of possible seizures. The purposes of this study was to determine the feasibility of using a systematic seizure screening measure completed by loved ones or care providers to facilitate the identification of symptoms concerning for seizure activity.

Methods: A consecutive series of patients accompanied by an informant presenting to the geriatric memory assessment clinic over a 6-month period were screened for possible symptoms and signs suggesting seizures. The informants completed a seizure screening questionnaire based on Baker et al. (2019). Caregivers also completed the Lawton Instrumental Activities of Daily Living Scale (Lawton). As part of the evaluation, the Mini Mental State Examination (MMSE) was administered on the day of the memory clinic evaluation.

Results: There were 149 individuals without a history of epilepsy or frank seizures (75 males and 74 females) who were screened for seizure related symptoms. The average age was 77.79; the average MMSE score of the total sample was 24.9; and the average Lawton score was 4.8. There were 86 (57.33%) individuals (45 males and 41 females) who endorsed at least 1 sign or symptom of possible seizures. The two most frequently endorsed symptoms were lack of responsiveness (n=64) and behavioral or speech arrest (n=43). The mean MMSE score for the possible seizure group was 24.83 and the mean Lawton score was 4.30. There were a total of 65 individuals (34 males and 31 females) who did not endorse any signs or symptoms of seizures. The average MMSE score was 25.80 and the average Lawton score was 5.49. The differences in MMSE scores was not statistically significant (p=0.365); however, the Lawton scores were significantly different (p=0.013).

Conclusions: Over half (57.3%) of the patients presenting to a geriatrics memory assessment clinic endorsed possible seizure activity on an informant based questionnaire. This raises concerns regarding the presence of epilepsy and requires further confirmation. Similar to Baker et al. (2019), we did not find any differences between the groups on a mental status screening measure, but we found a significant difference on a measure of functional status. This study demonstrated that a systematic screening measure completed by caregiver can assist in the identification of possible seizure activity. Future work will determine which symptoms or combination of symptoms are associated with EEG abnormalities as well as severity of cognitive diagnosis (MCI vs. Alzheimer’s disease).

Funding: Please list any funding that was received in support of this abstract.: None.