The increased risk of mortality in elderly patients with epilepsy and dementias
Andrade, Rogger Americo
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Studies have shown that individuals with Alzheimer’s disease or related dementias have increased risk of developing seizures. Alzheimer’s disease is the most prevalent form of dementia affecting millions of individuals across the nation and as we this number continues the rise, we suspect that cases of seizures in elderly patients is on the rise as well. Although there are advanced neuroimaging techniques that expand our current understanding of neural processes and interplay between neurological diseases, we are still limited in our insight into the causes and progression of Alzheimer’s disease and related Dementias (ADRD) and epilepsy. We are aware that elderly patients with ADRD and epilepsy deteriorate neurologically but it also gives rise to a significant public health issue; patients with ADRD and seizures suffer from social, financial and health restrictions as well. Overall, there is scarce evidence identifying the impact of having comorbid seizures and ADRD. In this study, we performed a retrospective cohort study comparing the 5-years mortality risk of patients with both seizures and dementia to patients with other neurological conditions. Patient data was retrieved from Research Patient Data Registry query and a subsample was selected for medical records abstraction using an ICD-9 code for “epilepsy” (345.xx), or “convulsions” (780.3x), or “collapse” (780.2x) from 2006-2013 and one claim for ADRD (331.x) within 2006-2013. Our results indicated that the rate of mortality is higher among patients with a history of seizures and ADRD when compared to patients seen in neurology for other conditions. While previous studies have indicated the increased risk of seizure development in elderly patients with ADRD, they did not examine mortality rates. These results amplify the need to careful examination of elderly patients who are at risk and can improve the quality of care they receive.