Cognitive Decline in People Living with Epilepsy Quantified in New Study

People currently living with epilepsy experienced cognitive decline at a faster rate than those with resolved epilepsy and those without epilepsy, according to a recent study. Additionally, people with epilepsy who also had cardiovascular risk factors, such as high blood pressure or diabetes, were 20% more likely to experience cognitive decline than those without these risk factors. These study results were presented at the 2023 American Epilepsy Society (AES) Annual Meeting.

The study, which took place between 2005 and 2021, was conducted to evaluate the transition from healthy cognition to mild cognitive impairment (MCI) and from MCI to dementia in people with current epilepsy, resolved epilepsy, and without epilepsy. Researchers also analyzed the role that comorbid cardiovascular risk factors played in cognitive decline. A total of 13,700 cognitively healthy participants were enrolled in the study from 39 Alzheimer disease (AD) centers across the United States, of whom 1% had epilepsy. Regardless of demographic characteristics, analysis of the study results demonstrated that people with epilepsy experience earlier decline in memory function than those without epilepsy, especially when cardiovascular risk factors are also present. Conversion from normal cognition to MCI occurred after 5 years in people with current epilepsy, 8 years in people with resolved epilepsy, and 10 years in those without epilepsy.

“It is important to identify epilepsy promptly and treat it aggressively to help slow or prevent this decline in older adults who are cognitively healthy,” said Ifrah Zawar, MD, lead study author. “In addition, early screening and targeted interventions towards modifiable cardiovascular risk factors may also help delay the onset of dementia.”

Notably, the study found that the rate of cognitive decline from MCI to dementia was the same for participants regardless of whether they had epilepsy, likely because of the more major role that cardiovascular risk factors play in the later stages of dementia.