Seizures Predict Cognitive Decline in Cognitively Healthy Adults
Abstract number :
2.172
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2023
Submission ID :
577
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: ifrah zawar, MD – University of Virginia
jaideep Kapur, MD PhD – Professor, Neurology, University of Virginia; Meghan Mattos, PhD – Assistant Professor, University of Virginia; carol Manning, PhD – Professor, Neurology, University of Virginia; mark Quigg, MD – Professor, Neurology, University of Virginia
Rationale:
Co-morbid seizures are common in those with dementia and are associated with accelerated cognitive decline in those with dementia. A handful of studies have studied the impact of seizures independent of cardiovascular risk factors on cognitive conversion to dementia. However, the impact of seizures on the cognitive conversion of cognitively healthy to mild cognitive impairment (MCI) and of those with MCI to dementia is not well-studied after accounting for cardiovascular risk factors.
Methods:
We analyzed multicenter, longitudinal data of 44,713 patients recruited prospectively from 39 Alzheimer’s Disease Centers in the US from September 2005 through December 2021. Montreal Cognitive Assessment scores defined two groups: conversion from 1) normal to mild cognitive impairment (MCI) and 2) MCI to dementia. The effect of seizures at the initial visit and covariates of age, sex, education, race, hypertension, and diabetes, on conversion risk was analyzed using Cox regression.
Results:
Seizures predicted earlier conversion time (Figure 1A) from normal cognition to MCI (hazard ratio (HR): 1.225; 95% CI: [1.017, 1.476], p=0.033) but were not associated with MCI to dementia conversion (HR: 1.158; [0.914, 1.468], p=0.225). In both groups, older age, female sex, lower education, presence of hypertension, and diabetes were associated with increased conversion risk.
Conclusions:
Our findings suggest that seizures predict earlier cognitive decline independently from known risk factors of dementia (age, sex, education, and race) and cardiovascular risk factors, including hypertension and diabetes, in those with normal cognition. However, the rate of cognitive decline from MCI to dementia is comparable in those with and without seizures.
Funding: Alzheimer's Association, NIH NeuroNEXT, BAND foundation
Clinical Epilepsy