2023-05-10 17:02:09
Focal epilepsy is associated with a higher risk of dementia, compared to stroke or migraine. This effect is further enhanced by a high cardiovascular risk, according to an analysis of UK Biobank data.
The UK Biobank contains data on more than 500,000 individuals. Participants were eligible for this analysis if they had no dementia at baseline and had clinical data on focal epilepsy, stroke, or migraine. The baseline assessment was conducted between 2006-2010 and participants were followed up to 2021. The aim was to compare the risk of dementia in patients with focal epilepsy versus stroke and migraine, as well as healthy controls, stratified by cardiovascular risk.
Of the 495,149 participants (45.5% male; mean age 57.5 years), 3,864 had a diagnosis of focal epilepsy, 6,397 had a history of stroke, and 14,518 had migraine. Executive function was comparable between participants with epilepsy and stroke and was worse than in the control and migraine groups. Focal epilepsy was associated with a greater risk of developing dementia (HR 4.02; p < 0.001) compared with stroke (HR 2.56; p < 0.001) or migraine (HR 1.02; p = 0.94 ). Participants with focal epilepsy and high cardiovascular risk were even more than 13 times more likely to develop dementia (HR 13.66; p < 0.001) than controls with low cardiovascular risk. Analysis of the imaging subgroup (n = 42,353) showed that focal epilepsy was associated with lower hippocampal (p = 0.03) and total gray matter volume (p < 0.001) compared to controls. There was no significant difference in the volume of white matter hyperintensity (p = 0.26).
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#Association #focal #epilepsy #dementia #cardiovascular #risk #factors