Abstracts

Rationale: As the population ages, it is critical that physicians are capable of managing all chronic illness, including epilepsy, the third most common neurological condition of the elderly. Optimal treatment of epilepsy should include understanding health related quality of life (HRQOL), a state of complete physical, mental, and social well-being, in addition to seizure control; however, limited information is available to guide HRQOL issues among elderly. The goal of this study is to assess HRQOL in the elderly population with epilepsy, using both a seizure-specific and a generic instrument. Methods: The Quality of Life in Epilepsy Inventory (QOLIE-31) and The Short Form 36 (SF-36) were mailed to 56 patients age 60 and older with established diagnosis of epilepsy at Via Christi St Francis Comprehensive Epilepsy Center. Results: Of the 56 surveys, 23 responded, a 41% response rate (mean age=60, age range=60-82). Our sample’s overall QOLIE-31 scores (average=62.74) were not different from that of adult epilepsy populations (average=62.87) for which the QOLIE-31 scores were standardized [Figure 1]. Our study suggests overall QOLIE-31 score correlates with total SF-36 score (QOLIE-31 score was similar to SF-36 score). However, our SF- 36 scores were significantly lower than that of general adult population without epilepsy, t (22) = -2.228, p = 0.036. All eight of the subscale average scores were lower than the norms, and five were significantly low: physical function, t(22)= -3.641, p = 0.001; role-physical, t(22) = -3.517, p = 0.002; general health, t(22) = -2.541, p = 0.019; social functioning, t(22) = -2.861, p =0.009; and role-emotional, t(22) = -2.909, p = 0.008 [Table 1]. Our participants reported significantly greater limitations due to their poor emotional and physical problems than that of general adult population. QOLIE-31 epilepsy-specific items indicate that though seizure worry tends to be less of a concern than general epilepsy population, 74% of our participants are worried about the long-term side effects of their anti-epileptic drug (AEDs); 61% reported physical side effects of AEDs, and 65% reported mental side effects of AEDs. Conclusions: We conclude that seniors with epilepsy do not necessarily have poor HRQOL compared to the general populations with epilepsy. However, when compared to general adult populations, seniors with epilepsy report a significantly lower HRQOL across all domains. Though seizures are generally easily controlled in elderly, it is possible that AED side effects and depression may be affecting their HRQOL. Multiple factors that may uniquely affect HRQOL among elderly populations with epilepsy include: aging variables (dementia, stroke, etc.), comorbid conditions (depression), and epilepsy variables (independence issues, AED side effects, unpredictability of seizure etc.). However, to our knowledge, there is no one instrument that addresses all of these aspects. The development of HRQOL instruments specifically for an elderly population with epilepsy may be useful and needed.