Epilepsy in the Elderly

Ann Johnston; Phil EM Smith


Expert Rev Neurother. 2010;10(12):1899-1910. 

In This Article

Quality of Life

Epilepsy can substantially disrupt quality of life in the elderly, as at any age. Elderly people appear particularly vulnerable to the side effects of AEDs and also their frailty and medical comorbidities put them at risk of physical injury. Although Baker in 2001 commented that elderly patients are also more likely to be anxious or depressed than younger patients,[71] these findings are not universal.[72] Epilepsy in the elderly undoubtedly contributes to social isolation, withdrawal, anxiety and depression. Living alone may make the unpredictable nature of epilepsy more problematic. The stigma of epilepsy may be especially relevant to people whose ideas regarding seizures were formed in a less open society. It is not surprising that a new diagnosis of epilepsy in older patients is potentially life changing and may result in a premature admission to nursing and residential facilities.[30] Therefore, it is clear that the treatment of epilepsy in the elderly is about far more than simply controlling seizures and must also focus upon quality of life.

Pugh et al. used the Veterans Affairs databases to assess the impact of epilepsy on health status in three cohorts; young (18–40 years), middle-aged (41–64 years) and older adults (65 years plus). Apart from physical status measures, older patients coped better with their epilepsy than middle-aged patients did.[72] Younger patients reported poor general health and worse mental health, but high levels of physical function and health. Middle-aged patients with epilepsy reported low levels of physical function, general health, social function and mental health.[72] This suggests that, despite epilepsy in the elderly being typically associated with anxiety, depression and a low quality of life, and despite their physical comorbidities, many older people cope relatively well with epilepsy and other chronic illnesses. This apparent acceptance may simply reflect a population who has already begun coping and adapting to other illnesses.


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