Seizures associated with earlier decline to MCI in cognitively healthy adults

Key takeaways:

• Seizures were not associated with mild cognitive impairment to dementia conversion.
• Cognitive decline risk was associated with older age, female sex, hypertension and diabetes.

ORLANDO — In cognitively healthy adults, the presence of seizures predicted earlier change from normal cognition to mild cognitive impairment but was not associated with change from MCI to dementia. according to research.

“Comorbid seizures are common in those with dementia and are associated with accelerated cognitive decline in those with dementia,” Ifrah Zawar, MD, lead study author and assistant professor in the department of neurology at the University of Virginia, and colleagues wrote in a presentation at the American Epilepsy Society annual meeting.

As there is limited research on the subject, Zawar and colleagues sought to examine the impact of seizures independent of cardiovascular risk factors on cognitive decline, as well as their impact on cognitively healthy individuals, patients with MCI and on patients with MCI progressing dementia.

Their multicenter, longitudinal study analyzed data from 44,713 individuals recruited prospectively from 39 Alzheimer’s disease centers in the United States from September 2005 to December 2021. The study population was split into two groups according to Montreal Cognitive Assessment (MoCA) scores: conversion from normal cognition to MCI and conversion from MCI to dementia. Researchers utilized Cox regression to analyze effects of seizures at the initial visit and covariates of age, sex, education, race, hypertension and diabetes on conversion risk.

According to results, seizures predicted earlier conversion time from normal cognition to MCI (HR: 1.225; 95% CI, 1.017, 1.476) but were not associated with MCI to dementia conversion (HR: 1.158; 0.914, 1.468). In both groups, increased conversion risk was associated with older age, female sex, lower education, presence of hypertension and diabetes.

“While epilepsy itself is associated with [mild cognitive impairment] and dementia, this risk is substantially magnified in those who also have high blood pressure, diabetes or other cardiovascular risk factors,” Zawar said in a related release. “Early screening and targeted interventions towards modifiable cardiovascular risk factors may also help delay the onset of dementia.”

Reference:

• Epilepsy associated with early cognitive decline, study finds. Published Dec. 1, 2023. Accessed Dec. 1, 2023.