PT  - JOURNAL ARTICLE
AU  - Johnson, Emily L.
AU  - Krauss, Gregory L.
AU  - Kucharska-Newton, Anna
AU  - Albert, Marilyn S.
AU  - Brandt, Jason
AU  - Walker, Keenan A.
AU  - Yasar, Sevil
AU  - Knopman, David S.
AU  - Vossel, Keith A.
AU  - Gottesman, Rebecca F.
TI  - Dementia in late-onset epilepsy
AID  - 10.1212/WNL.0000000000011080
DP  - 2020 Dec 15
TA  - Neurology
PG  - e3248--e3256
VI  - 95
IP  - 24
4099  - http://n.neurology.org/content/95/24/e3248.short
4100  - http://n.neurology.org/content/95/24/e3248.full
SO  - Neurology2020 Dec 15; 95
AB  - Objective To determine the risk of dementia after the development of late-onset epilepsy.Methods We used data from the Atherosclerosis Risk in Communities (ARIC) cohort study, which started in 1987 to 1989 with 15,792 mostly Black and White men and women from 4 US communities. We identified late-onset epilepsy (LOE; seizures starting at age 67 or later) from linked Medicare claims data. We used a Cox proportional hazards regression model to evaluate associations between LOE and dementia through 2017 as ascertained from neuropsychological testing, interviews, and hospital discharge surveillance, and we used multinomial logistic regression to assess the risk of dementia and mild cognitive impairment in the subset with full neuropsychological assessments available. We adjusted for demographics and vascular and Alzheimer disease risk factors.Results Of 9,033 ARIC participants with sufficient Medicare coverage data (4,980 [55.1%] female, 1993 [22.1%] Black), 671 met the definition of LOE. Two hundred seventy-nine (41.6%) participants with and 1,408 (16.8%) without LOE developed dementia (p < 0.001). After a diagnosis of LOE, the adjusted hazard ratio for developing subsequent dementia was 3.05 (95% confidence interval 2.65–3.51). The median time to dementia ascertainment after the onset of LOE was 3.66 years (quartile 1–3, 1.28–8.28 years).Interpretation The risk of incident dementia is substantially elevated in individuals with LOE. Further work is needed to explore causes for the increased risk of dementia in this growing population.AD=Alzheimer disease; ARIC=Atherosclerosis Risk in Communities; BMI=body mass index; CI=confidence interval; CMS=Centers for Medicare & Medicaid Services; FFS=fee-for-service; HR=hazard ratio; ICD=International Classification of Diseases; LOE=late-onset epilepsy; MCI=mild cognitive impairment; RRR=relative risk ratio