Epilepsy and Aging

Little is known about the effect that aging has on cognitive and brain health in people with chronic epilepsy. But research has shown seniors have an increased prevalence of developing the disorder. About 300,000 seniors in the United States have seizures and they are the fastest growing population group with epilepsy.

Seniors and epilepsy

According to to Greg Cascino, M.D., F.A.A.N., Whitney MacMillan, Jr. Professor of Neuroscience, at the Mayo Clinic College of Medicine and chair of the Division of Epilepsy at Mayo Clinic, older individuals may be at greater risk of developing a seizure disorder because of the neurological illnesses that may occur in the elderly--such as stroke and heart attack-- which are associated with seizures because they can damage the brain. About 33 percent of all cases of senior epilepsy are caused by stroke, the most common cause of seizures in older adults. Alzheimer’s disease is the second most common cause of epilepsy in seniors.

Some studies suggest that certain cognitive deficits, neuroimaging abnormalities and psychiatric disorders found in younger people with epilepsy may progress as patients get older. In addition, medications to treat the condition may have negative effects on health later in life. Still, there is no evidence that people with epilepsy are at a higher risk of developing Alzheimer’s disease or dementia, according Dr. Cascino.

Seizures may be an early sign of Alzheimer’s

Though having epilepsy doesn’t put a person at greater risk for developing Alzheimer’s disease (AD), having AD does increase the risk for having seizures.  And having Alzheimer’s disease or amnestic mild cognitive impairment (aMCI) and seizures causes greater cognitive decline, more rapid progression of symptoms and more severe neuronal loss, compared to people with Alzheimer’s disease but without seizures, according to a 2013 study from the Gladstone Institute of Neurological Disease, San Francisco, CA.

For the study, researchers looked at 54 patients with a diagnosis of aMCI and epilepsy, AD and epilepsy or AD and subclinical epileptiform activity. They found that patients with aMCI who had epilepsy had symptoms of cognitive decline 6.8 years earlier than patients with aMCI who did not have epilepsy. Patients with AD who had epilepsy showed cognitive decline 5.5 years earlier than patients with AD who did not have epilepsy.

Researchers said that careful identification and treatment of epilepsy in patients with Alzheimer’s or aMCI may improve their outcome.

Bottom line

Dr. Cascino says that some people with epilepsy do have cognitive problems or memory loss related to their seizures, or underlying neurological problems causing their epilepsy. And, though it is possible that seizures activity may change with age, the effect is variable.