Abstracts

Objective: Participants should be able to identify cognitive and emotional trends relating to health-related QOL that differ between seniors with epilepsy and healthy seniors.
Our current understanding of the cognitive and emotional consequences in epilepsy has evolved in large part from studies of younger persons with epilepsy. The information generated from neuropsychological studies may have generalizability to senior adults, however aging presents its own set of unique aspects to the study of cognitive function. This study is aimed at generating a description of the neuropsychological profile of elderly persons with epilepsy and contrasting it with a sample of healthy seniors using quantitative techniques.
METHODS: Participants with epilepsy (n=19) were recruited from area outpatient neurology clinics and healthy seniors (n=29) were recruited from regional area senior centers. All participants were at least 60 years old, independent community dwelling, 6th grade education or higher, no history of substance/alcohol abuse, and no history of progressive CNS disease. Epilepsy patients experienced at least one seizure within the previous 3 months of enrollment. Epilepsy seniors were not restricted from the study based upon seizure type due to etiologies of stroke, brain cancer, traumatic brain injury. Most patients had idiopathic etiology. Standardized measures of cognitive, emotional, physical (Adverse Events Profile) functioning were administered in a single session. Specific tests were the Dementia Rating Scale (DRS), Logical Memory test (LM) of the WMS-III, Boston Naming Test, Wide Range Acheivement Test, Grooved Pegboard Test, Executive Interview Test, Geriatric Depression Scale and Profile of Mood State. A series of one-way ANOVAs were performed to establish between group differences.
RESULTS: Seniors with epilepsy were younger than healthy controls (64 versus 72 years old, p [lt].001) and had slightly more years of education (13 versus 12). Females were more prevalent in the epilepsy group (12 vs. 7males) compared to less females in the healthy senior group (17 vs. 12 males). Seniors with epilepsy had average age of onset at 33 years old (range 11-63) with majority having seizure onset before age 40. Healthy seniors were taking an average of two medications (primarily hypertensive and arthritis medications) while epilepsy seniors received an average of two antiepilepsy medications. Epilepsy seniors performed below that of healthy controls on a global measure of cognitive function (DRS, p [lt].04), verbal memory (LM immediate recall, p [lt].05), along with trends for BNT (p [lt] .08), LM delay (p [lt].09). Age of seizure onset was not related to cognitive performance. Epilepsy seniors reported significantly more affective and physical distress than healthy seniors (Adverse Events, p [lt].02; GDS, p[lt].01; POMS, p [lt].01). Symptoms of restlessness, tension/anxiety, depression and fatigue were more characteristic of epilepsy seniors.
CONCLUSIONS: These results provide preliminary evidence that epilepsy in seniors may have mild detrimental effects upon cognitive, emotional, and physical functioning compared to healthy seniors. Cognitive dysfunction was most evident on measures of memory and global cognitive function. These results were especially interesting in light of the fact that epilepsy seniors were younger and had slightly more education than healthy seniors.
[Supported by: Centers for Disease Control and Prevention.]