Abstracts

Rationale: The incidence of new-onset epilepsy is highest after age 60, and continues to rise steadily as the life expectancy in the U.S. increases. Despite knowledge that older adults are significantly affected by new-onset epilepsy, little research has been done with this population, and research findings generated from studies involving younger adults with epilepsy have commonly been applied to older adults. Doing so is inappropriate given unique characteristics of older adults with new-onset epilepsy (epilepsy etiologies, clinical presentation, prognosis, metabolic and cognitive changes, co-morbidities, and polypharmacy). Thus, how new-onset epilepsy affects the lives of older adults, and problems they experience as a result of epilepsy, is unknown. To guide intervention development and improve epilepsy self-management outcomes, such knowledge must be generated. The purpose of this qualitative descriptive study was to describe problems and life changes experienced by older adults affected by new-onset epilepsy at or after age 60 since the time of epilepsy diagnosis. Methods: 20 persons aged 60 or older were purposively sampled from a regional neurology office. Inclusion criteria included diagnosis of epilepsy at or after age 60 years, diagnosis of epilepsy at least six months prior to recruitment into the study, prescription of at least one anti-epileptic drug, community-dwelling, and able to speak and read English. Potential participants were sent a letter informing them of the study, and the researcher later called them to invite them to take part. Those who met inclusion criteria and desired to participate met with the researcher for a face-to-face, audio-recorded semi-structured interview. Participants were asked open-ended questions pertaining to problems and perceived changes experienced since being diagnosed with epilepsy. Interview data were transcribed and analyzed using content analysis. Results: 12 women and 8 men took part in the study. The mean age was 70 years, with a range of 60-80 years. The mean length of time since epilepsy diagnosis was 4.1 years, with a range of 0.5-10 years. Participants reported that they had experienced problems in the following areas since being diagnosed with epilepsy: Maintaining Independence, Medications, Achieving Goals, and Memory (Table 1). Participants reported that they had experienced both negative and positive changes since diagnosis. Negative changes included those pertaining to lifestyle, perceived well-being, and physical/emotional symptoms. Positive changes were experienced regarding relationships with family and friends, perspective, and spirituality (Table 2). Conclusions: Findings from this study demonstrate that older adults with new-onset epilepsy are at risk for experiencing problems and perceived negative life changes that are unique from those of younger adults with epilepsy. These results can inform the development of an assessment tool which can be used to guide the development and implementation of tailored epilepsy self-management interventions for this population.