SEATTLE—Epilepsy is associated with an increase in mortality among elderly veterans, a rate that is higher for those who have a new diagnosis of epilepsy compared with a pre-existing diagnosis, researchers reported at the 68th Annual Meeting of the American Epilepsy Society.
Perry Foreman, MD, PhD, and colleagues used VA administrative data to identify veterans age 66 and older who received VA care in fiscal years 2005 and 2006. The veterans were classified as the epilepsy cohort or the nonepilepsy cohort based on a previously validated algorithm. The primary outcome measure was mortality within the epilepsy and nonepilepsy cohort groups, which was compared with a no-epilepsy cohort using the VA minivital status file. In addition, the investigators identified covariates that included patient demographics (age, gender, and race), disease burden, and comorbid conditions.
In a previous study of elderly veterans with a new diagnosis of epilepsy, the investigators had found “an extremely high absolute mortality of 12% at one year, and 32.9% within three years,” according to Dr. Foreman, an epileptologist at the Epilepsy Center, LifeBridge Health Brain & Spine Institute in Baltimore.
In their current study, for 2006, Dr. Foreman and colleagues identified 35,611 veterans with chronic epilepsy and 1,412 veterans with a new diagnosis of epilepsy. In the chronic epilepsy veteran group, 2,468 deaths (6.9%) occurred, and in the new epilepsy group, 131 deaths (9.3%) occurred, “which is almost double the one-year mortality seen in the no-epilepsy cohort (4.1%),” stated the researchers. Mortality was primarily associated with comorbid disease, with the highest associations occurring with cancer, various cardiac conditions, and dementia.
“Mortality is elevated for both groups,” reported Dr. Foreman. “However, when compared with age-matched veterans who do not have epilepsy, the majority of the mortality variance appears to be accounted for by the presence of comorbid medical conditions.”