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Predictors of incident epilepsy in older adults: The Cardiovascular Health Study.
Monday,2017-05-01 16:17 America/Los_Angeles — ecterry
| Title | Predictors of incident epilepsy in older adults: The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Choi, H, Pack, A, Elkind, MSV, Longstreth, WT, Ton, TGN, Onchiri, F |
| Journal | Neurology |
| Volume | 88 |
| Issue | 9 |
| Pagination | 870-877 |
| Date Published | 2017 Feb 28 |
| ISSN | 1526-632X |
| Abstract | <p><b>OBJECTIVE: </b>To determine the prevalence, incidence, and predictors of epilepsy among older adults in the Cardiovascular Health Study (CHS).</p><p><b>METHODS: </b>We analyzed data prospectively collected in CHS and merged with data from outpatient Medicare administrative claims. We identified cases with epilepsy using self-report, antiepileptic medication, hospitalization discharge ICD-9 codes, and outpatient Medicare ICD-9 codes. We used Cox proportional hazards regression to identify factors independently associated with incident epilepsy.</p><p><b>RESULTS: </b>At baseline, 42% of the 5,888 participants were men and 84% were white. At enrollment, 3.7% (215 of 5,888) met the criteria for prevalent epilepsy. During 14 years of follow-up totaling 48,651 person-years, 120 participants met the criteria for incident epilepsy, yielding an incidence rate of 2.47 per 1,000 person-years. The period prevalence of epilepsy by the end of follow-up was 5.7% (335 of 5,888). Epilepsy incidence rates were significantly higher among blacks than nonblacks: 4.44 vs 2.17 per 1,000 person-years (p < 0.001). In multivariable analyses, risk of incident epilepsy was significantly higher among blacks compared to nonblacks (hazard ratio [HR] 4.04, 95% confidence interval [CI] 1.99-8.17), those 75 to 79 compared to those 65 to 69 years of age (HR 2.07, 95% CI 1.21-3.55), and those with history of stroke (HR 3.49, 95% CI 1.37-8.88).</p><p><b>CONCLUSIONS: </b>Epilepsy in older adults in the United States was common. Blacks, the very old, and those with history of stroke have a higher risk of incident epilepsy. The association with race remains unexplained.</p> |
| DOI | 10.1212/WNL.0000000000003662 |
| Alternate Journal | Neurology |
| PubMed ID | 28130470 |
| PubMed Central ID | PMC5331867 |
ePub date:
17/01