Epilepsy May Signal Future Dementia Risk

Medscape

4 hours ago

Epilepsy prevalence was significantly higher among people with frontotemporal dementia (FTD) than among those with Alzheimer's disease (AD), a new study showed, with epilepsy occurring in some cases up to 10 years before an FTD diagnosis.
METHODOLOGY:
In a case-control study in Finland, epilepsy prevalence and antiseizure medicine ( ASM) purchases were compared between 245 patients with FTD (mean age at diagnosis, 65 years; 49% women), more than 1300 patients with AD (mean age, 72 years; 59% women), and more than 2400 individuals matched for age, sex, and location to act as the healthy control group (mean age, 65 years; 49% women).
Data were collected from 2010 to 2021, and epilepsy cases were identified using codes from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10).
Purchases of ASMs were tracked throughout the study period, and epilepsy prevalence was evaluated at four timepoints: 10 years before the diagnosis of FTD, 5 years before diagnosis, at diagnosis, and 5 years after diagnosis.
TAKEAWAY:
Both epilepsy prevalence and ASM purchases were significantly greater in patients with FTD than in those in the healthy control group at all timepoints ( P < .001 for both measures).
< .001 for both measures). Epilepsy prevalence was significantly higher in patients with FTD than in patients with AD 10 years before ( P = .03), 5 years before ( P = .002), and 5 years after ( P = .05) the diagnosis of FTD.
= .03), 5 years before ( = .002), and 5 years after ( = .05) the diagnosis of FTD. The prevalence of ASM use was also significantly higher among patients with FTD than among patients with AD ( P = .004 at 5 years before FTD diagnosis and P < .001 at other timepoints).
= .004 at 5 years before FTD diagnosis and < .001 at other timepoints). After adjusting for age at the time of FTD diagnosis, the risk for mortality was not significantly different between patients with both FTD and epilepsy and those without epilepsy.
IN PRACTICE:
'It is noteworthy that epilepsy occurred in some patients with FTD already 10 years before their dementia diagnosis, and it was more common in all the examined stages of the disease than previous international studies have reported,' lead investigator Annemari Kilpeläinen, MD, Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland, said in a press release.
The researchers added that 'enhancing knowledge of the comorbidity between epilepsy and FTD could lead to more precise and comprehensive diagnostics and treatment of these conditions as well as new pathophysiologic findings.'
SOURCE:
The study was published online on June 2 in JAMA Neurology .
LIMITATIONS:
This study was limited by reliance on ICD-10 codes for classification of epilepsy types and included only two major provinces in Finland. Additionally, epilepsy diagnoses recorded before 1998 may have been missed.
DISCLOSURES:
This study was part of the Real-World Data Project on Neurodegenerative Diseases, funded by Roche OY. Additional funding was provided by the Kuopio University Hospital, the Finnish Brain Foundation, the Uulo Arhio Foundation, the Finnish Medical Foundation, the Finnish Cultural Foundation, the Wihuri Foundation, and the Sigrid Juselius Foundation. Several investigators reported having ties with various organizations and pharmaceutical companies. Full details are provided in the original article.