The Clinical and Cognitive Profiles of Individuals with Alzheimer’s Disease and Co-morbid Seizures
Abstract number :
2.015
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2024
Submission ID :
761
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Anny Reyes, PhD – Cleveland Clinic
Ifrah Zawar, MD, MS-CR – University of Virginia
Vineet Punia, MD – Cleveland Clinic
Rani Sarkis, MD, MSC – Brigham and Women's Hospital, Harvard Medical School
Jaideep Kapur, MBBS, PhD – University of Virginia
Robyn Busch, PhD – Cleveland Clinic
Bruce Hermann, PhD – University of Wisconsin
Carrie McDonald, PhD – UCSD
Rationale: Seizures are a highly prevalent comorbidity in Alzheimer’s disease (AD), with population-based studies reporting a 2 to 6-fold increased risk. The presence of seizures has been associated with accelerated cognitive decline. Despite the rapid increase in research aimed at detecting and treating seizures in AD, no studies have fully characterized the cognitive profiles of patients with co-morbid AD and epilepsy utilizing comprehensive neuropsychological approaches.
Methods: Clinical and cognitive data were obtained from participants 65 years and older diagnosed with dementia due to AD as part of the National Alzheimer’s Coordinating Center (NACC) Unified Data Set. Cognitive data included measures of memory, language, attention, processing speed, and executive function. Raw scores were converted into z-scores based on data from a robust sample of normal controls with no history of seizures (N=14,665). Mann Whitney U and chi-square tests were conducted to examine differences in clinical, sociodemographic, and cognitive data between participants with and without seizures. In a sensitivity analysis, participants with a history of stroke were removed from the AD-Seizures group.
Results: Approximately 1.2% (n=117) of the AD cohort (N=9,662) had active seizures. Participants with seizures (AD-Seizures) were younger, more likely to have a history of stroke or transient ischemic attack and had a higher Hachinski Ischemic Score (Table 1; ps< .05). The AD-Seizures group demonstrated an earlier age at the onset of cognitive decline, longer disease duration, lower MMSE scores, and higher Clinical Dementia Rating Scale sum of boxes (ps< .05). The AD-NoSeizures group were more likely to live alone. The AD-Seizures group demonstrated poorer performance on measures of attention/working memory, processing speed, language (naming and semantic fluency), and executive function compared to the AD-NoSeizures group (Figure 1). After excluding participants with stroke, differences in cognitive performance remained significant for all measures except semantic fluency.
Behavior