What do we know up to now about epilepsy developing in later age (60 years and over)?
What is it about?
We set out to find research studies which had explored the development of epilepsy in adult aged 60 years and over. In particular, we focused on the causes, treatment, course of the condition and the psychological and social effects on daily living. We identified 22 studies, 4 randomised clinical trials looking at treatment with different anti-epileptic drugs compared to placebo, 1 uncontrolled study which looked at surgery as a treatment, and 5 studies that looked at brain function and psychological issues. The specific features experienced by a person 60 years and over does significantly influences the choice of treatment. Newer generation anti-epileptic drugs were found to be better tolerated by older adults. For adults in later age who develop uncontrolled seizures in which drugs are not effective, surgery is a safe option and does result in good outcomes for people. Cognitive and psychiatric screening before treatment may be useful for management. Brain function, e.g. memory loss and fatigue, can be quite significantly weakened in older people with epilepsy. Depression and anxiety are also key psychological issues which develop in addition to epilepsy which impairs people's quality of life and ability to function in their later age. A need for formal clinical practice guidelines to be developed to assist health providers to provide good management was identified too.
Why is it important?
People who are 60 years old and older have the highest incidence of developing new-onset epilepsy. The increase in the ageing population has resulted in a greater number of patients with new-onset epilepsy or at risk of developing the condition. Older adults who have experienced a stroke or Alzheimer's disease have a higher chance of developing epilepsy too. More high quality research studies are required to provide greater treatment options to be available for doctors and patients in later age, and in particular for those with Alzheimer's disease who also develop epilepsy.
The following have contributed to this page: Loretta Piccenna
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