Vascular Risk Factors and Alzheimer’s-related Biomarker Profiles in Older Adults with Early versus Late Onset Epilepsy
Abstract number :
3.337
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2023
Submission ID :
880
Source :
www.aesnet.org
Presentation date :
12/4/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Divya Prabhakaran, – University of California, San Diego
Anny Reyes, PhD – University of California, San Diego; Darwin Buckner, BS – University of California, San Diego; Alena Stasenko, PhD – University of California, San Diego; Adam Schadler, MS – University of California, San Diego; Lisa Ferguson, MA – Cleveland Clinic; Aaron Struck, MD – University of Wisconsin School of Medicine and Public Health; Vineet Punia, MD – Cleveland Clinic; Jana Jones, PhD – University of Wisconsin School of Medicine and Public Health; Robyn Busch, PhD – Cleveland Clinic; Bruce Hermann, PhD – University of Wisconsin School of Medicine and Public Health; Carrie McDonald, PhD – University of California, San Diego
Rationale: Older adults with epilepsy include those with chronic, early onset (EO) and those with late-onset epilepsy (LO; epilepsy starting at age 55 or later). Both cohorts are at increased risk for progressive cognitive decline and developing dementia. Etiologies associated with cognitive impairment in older adults with epilepsy vary from the accumulation of vascular risk factors to Alzheimer’s disease (AD) risk factors and related pathology including APOE ε4 allele, abnormal β-amyloid, and tau. However, little is known about whether the onset of epilepsy is associated with differential clinical and biomarker profiles. We compared the vascular and AD-related biomarker profiles of patients with EO and LO epilepsy.
Methods: Thirty-two older adults were prospectively recruited. A comprehensive lipid panel, plasma biomarkers (i.e., total Tau [tTau], phosphorylated-Tau [pTau], β-amyloid), and APOE genotyping were obtained. Vascular measures included hypertension, diabetes, hyperlipidemia, obesity (body mass index; BMI ≥30), pulse pressure proxy (systolic subtracted by diastolic blood pressure; PPP; a proxy measure of arterial stiffness), and a burden of vascular risk score was calculated and defined by the number of vascular risk factors present. Cutoffs for elevated plasma AD biomarkers were based on a normal control sample. Differences between EO and LO groups were tested with Chi-square and Mann-Whitney U tests.
Results: A total of 17 EO (mean age = 63.5 years; mean education = 16 years; 52.9% female; 70.6% Non-Hispanic White) and 15 LO (mean age = 69.9 years; mean Education = 15 years; 53.3% female; 86.7% Non-Hispanic White) patients were enrolled. Patients with LO had higher rates of hypertension (73.3% vs 27.6%, p=0.04) and higher PPP (p=.001). Total cholesterol (p = 0.24), triglycerides (p = 0.24), BMI (p = 0.65), and glucose (p = 0.68) did not significantly differ between onset groups. There were no significant differences in obesity (EO=50% vs LO=50%, p = 1.00), hyperlipidemia (EO=21.4% vs LO=33.3%, p = 0.47) or diabetes (EO=7.1% vs LO=33.3%, p = 0.08). However, there was a trend towards LO having a greater number of vascular risk factors (p=.09). There were no significant differences in APOE ε4 status (EO = 7.1% vs LO= 23.1%, p= 0.24), pTau (EO = 38.5% vs LO= 23.1%, p= 0.40), tTau (EO = 71.4% vs LO= 46.2%, p= 0.18), or β-amyloid 42/β-amyloid 40 (EO = 50.0% vs LO= 69.2%, p= 0.31).
Conclusions: We found differential biomarker profiles in older adults with epilepsy as patients with LO demonstrated higher rates of hypertension and increased arterial stiffness, suggesting that an accumulation of vascular risk factors may play a role in LO. These preliminary findings warrant continued investigation of the impact of AD-biomarkers and vascular risk factors on cognition. Further exploration of the underlying pathologies that differ between EO and LO (e.g., vascular risk or AD-like pathology) will lead to a better understanding of the clinical profiles of older adults with epilepsy and help identify patients at increased risk for dementia.
Funding: National Institute of Neurological Disorders and Stroke R01 NS120976.
Behavior