Epilepsy and antiepileptic drug use in elderly people as risk factors for dementia

Abstract Objective To assess the role of epilepsy and antiepileptic drugs (AEDs) as risk factors for probable Alzheimer's disease (AD) and for all dementias in the Canadian Study of Health and Aging (CSHA). A secondary objective was to isolate the effect of the AED phenytoin on the development...

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Published in:	Journal of the neurological sciences Vol. 252; no. 2; pp. 169 - 172
Main Authors:	Carter, M.D, Weaver, D.F, Joudrey, H.R, Carter, A.O, Rockwood, K
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier B.V 31-01-2007 Elsevier Science
Subjects:	Aged Aged, 80 and over Aging Alzheimer Disease - epidemiology Alzheimer's disease Anticonvulsants - therapeutic use Anticonvulsants. Antiepileptics. Antiparkinson agents Antiepileptic drugs Biological and medical sciences Canadian Study of Health and Aging (CSHA) Cohort Studies Dementia Epilepsy Epilepsy - drug therapy Epilepsy - epidemiology Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Male Medical sciences Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pharmacology. Drug treatments Phenytoin Phenytoin - therapeutic use Prospective Studies Risk Factors Canadian Study of Health and Aging (CSHA) Antiepileptic drugs Alzheimer's disease Epilepsy Phenytoin Dementia Human Nervous system diseases Senescence Alzheimer disease Anticonvulsant Cerebral disorder Central nervous system disease Risk factor Degenerative disease Elderly
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Summary:	Abstract Objective To assess the role of epilepsy and antiepileptic drugs (AEDs) as risk factors for probable Alzheimer's disease (AD) and for all dementias in the Canadian Study of Health and Aging (CSHA). A secondary objective was to isolate the effect of the AED phenytoin on the development of dementia and AD. Methods The cohort consists of 5376 participants aged 65 years or older with no evidence of dementia, defined as Modified Mini-Mental State (3MS) score ≥ 78. Primary exposure was self-report or clinical diagnosis of epilepsy at baseline ( n = 39), or self-report of AED therapy ( n = 67). Primary outcomes were development of dementia, defined as 3MS < 78, or AD, determined by clinical examination using standard criteria, during a 5-year follow-up period. People whose 3MS score remained ≥ 78 served as the comparison group. Results People reporting AED use at baseline had an age, sex and baseline 3MS adjusted odds ratio (OR) of 2.11 (95% CI 1.11 to 4.01) for developing dementia compared to those not taking AEDs at baseline. The association remained significant using only phenytoin as the exposure. No significant association was found between AED use and development of AD, nor between epilepsy and development of either AD or dementia. Conclusions Older adults taking AEDs are at a significantly higher relative risk of developing dementia than those not taking AEDs. Further investigation of this finding is warranted.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-510X 1878-5883
DOI:	10.1016/j.jns.2006.11.004