Clinical Edge

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Midlife Risk Factors Linked to Late-Onset Epilepsy

JAMA Neurology; ePub 2018 Jul 23; Johnson, et al

Potentially modifiable risk factors in midlife and the apolipoprotein E (APOE) ε4 genotype were positively associated with risk of developing late-onset epilepsy, a recent study found. Although stroke and dementia were both associated with late-onset epilepsy, vascular and lifestyle risk factors were significant even in the absence of stroke or dementia. This study included 10,420 black or white participants from Atherosclerosis Risk in Communities (ARIC) with at least 2 years of Medicare fee-for-service coverage and without missing baseline data. Researchers found:

  • Of total participants (5,878 women [56.4%] and 2,794 black participants [26.8%]; median age 55 years at first visit), 596 participants developed late-onset epilepsy (3.33 per 1,000 person-years).
  • The incidence was higher in black than in white participants.
  • In multivariable analysis, baseline hypertension, diabetes, smoking, APOE ε4 genotype, and incident stroke, and dementia were associated with an increased risk of late-onset epilepsy, while higher levels of physical activity and moderate alcohol intake were associated with a lower risk.
  • Results were similar after censoring individuals with stroke or dementia.
Citation:

Johnson EL, Krauss GL, Lee AK, et al. Association between midlife risk factors and late-onset epilepsy. Results from the Atherosclerosis Risk in Communities study. [Published online ahead of print July 23, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.1935.

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