Epilepsy and the Risk of Young-Onset Dementia

People with epilepsy face a higher risk of developing dementia before 65, according to a recent study analyzing health records from France and Sweden. Researchers observed epilepsy frequently in those later diagnosed with young-onset dementia, a type of dementia developing before age 65. This study, appearing in Neurology, a journal of the American Academy of Neurology, used research methods in both countries, yielding similar outcomes.

Dr. Rebecca Spiegel, a neurologist at Stony Brook Medicine, discussed the findings with Newsweek. “They are important, but we need to be cautious,” she stated. “In some patients, new seizures might be an initial sign of neurodegeneration rather than its cause. People with epilepsy might experience cognitive difficulties that do not necessarily mean dementia and might be treatable, particularly given the high incidence of depression and anxiety in this population.”

Link Between Epilepsy and Young-Onset Dementia

The researchers highlighted that the findings do not establish epilepsy as a direct cause of young-onset dementia. Instead, they found a strong association between the two conditions. Although the increase in risk was significant, the overall chance of developing young-onset dementia remained low. This type of dementia, less common than later-life dementias, can greatly affect individuals during their working and family-rearing years.

To explore potential links with epilepsy, researchers utilized national health databases in France and Sweden. Part of the study examined if people diagnosed with young-onset dementia previously had epilepsy or took epilepsy medication. Another analysis followed individuals with epilepsy over time to see if they later developed dementia.

In a retrospective analysis, researchers compared 11,360 French individuals with young-onset dementia against 113,600 peers without dementia matching in age and sex. In Sweden, 16,433 individuals with young-onset dementia were compared with 164,330 individuals without the condition.

The disparities were notable. In France, 12.5% of people with young-onset dementia had an epilepsy diagnosis, versus 1.2% without dementia. Researchers also noted 27.3% of those with dementia received epilepsy medications, compared to 10.3% without dementia. Swedish data showed similar patterns, affirming the findings’ reliability across different healthcare systems.

Tracking Epilepsy Patients Over Time

The second study aspect followed French adults aged 30 to 55, newly diagnosed with epilepsy in 2008, tracking them for up to 10 years. During follow-up, 2.2% of newly diagnosed patients developed young-onset dementia compared to 1.7% with pre-existing epilepsy and 0.2% without epilepsy.

After considering other dementia risk factors like stroke, mood disorders, and traumatic brain injuries, researchers discovered those newly diagnosed with epilepsy were six times more likely to develop young-onset dementia. People with existing epilepsy faced a 74% higher risk than those without the condition.

However, the study authors advised on some limitations. The databases lacked detailed information on specific dementia types or epilepsy forms among participants. Researchers also pointed out the study’s reliance on data from France and Sweden, both high-income countries with universal healthcare. These findings might not extend to different populations or healthcare settings.

While the study contributes to evidence linking epilepsy and cognitive decline, further research is required to understand the relationship and whether reducing epilepsy-related risks lowers young-onset dementia likelihood. “Despite the increased relative risk, the majority of epilepsy patients did not develop young-onset dementia,” Spiegel commented. “Still, the findings should encourage more attention to cognitive assessments in people with epilepsy.”