Mortality is Higher in Older Adults with Epilepsy

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By: Lance Fogan, MD

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Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

As my 15th monthly blog reviewed in December 2011 available on my website: LanceFogan.com, it’s surprising to many that the onset of epilepsy is currently most common in the over sixty-five age group versus the onset in children. While the incidence of epilepsy decreases in children over time it increases in the elderly population, in grandparents, whose brains are more apt to be afflicted with trauma and stroke scars, tumors, and other ailments (1, 2). Five to fifteen percent of patients will experience a seizure within two years after a stroke (3). Note that other ailments associated with aging, such as Alzheimer’s Disease and Parkinson’s Disease are not commonly associated with epilepsy.

Increased life expectancy has led to this larger proportion of elderly people in developed countries. Recent studies show that newly diagnosed epilepsy in older adults is associated with high 5-year mortality among Medicare beneficiaries. One study found a 5-year mortality rate of 62.8% in Medicare beneficiaries age 65 and older with new-onset epilepsy. This is more than double the 5-year mortality rate in the overall general Medicare population without epilepsy from which the sample was drawn. Death in older adults with epilepsy is common (4). Associated ailments that increased the hazard of death includes cancers, chronic heart disease, strokes, diabetes, chronic obstructive pulmonary disease (COPD) from years of smoking, osteoporosis associated with hip and other fractures, unhealthy diet, dementia, etc.

Researchers identified a total of 33,615,037 people, ages 65 and above, who had been enrolled in Medicare for at least 2 years on January 1, 2009. Of these, 99,990 (0.3%) were diagnosed with epilepsy in 2009. Nearly one third (29.2%) of the 33 million qualifying beneficiaries died during the 5-year observation period. The death rate was substantially higher in the incident epilepsy subpopulation: 62.8% (n = 62,838) died within 5 years. Future studies will use Medicare claims linked to electronic medical records to understand the interplay between race, sex, poverty, and comorbid disease on mortality and to determine the comparative effectiveness of newer epilepsy treatments in elderly patients with epilepsy (5).

Our senior epilepsy population must safeguard their health by taking current COVID-19 precautions, getting vaccinated, stop smoking and take medications as directed.

  1. Sillanpaa, et al. Epilepsy Res. 2006; Oct: 71 (2-3): 206-15.
  2. Hauser, W.A., et al. Mayo Clinic Proceedings 1996; 71: 576-586.
  3. Herman, S. Neurology, 2011: 77: 1776-1777.
  4. Lichtman JH, Jones SB, Leifheit-Limson EC, et.al.. 30-Day mortality and readmission after hemorrhagic stroke among Medicare beneficiaries in Joint Commission Primary Stroke Center-certified and noncertified hospitals. Stroke 2011;42:3387–3391.
  5. Leah J. Blank, Emily K. Acton, Allison W. Willis. Predictors of Mortality in Older Adults with Epilepsy Neurology October 21, 2020

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