Einzeltreffer — DigiBib

Objective: Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without.

Methods: Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black and Hispanic beneficiaries were oversampled. We identified preexisting chronic conditions from the 2016-2018 Medicare Beneficiary Summary Files and compared chronic condition prevalence between Medicare beneficiaries with and without incident epilepsy in 2019. We characterized variations in preexisting excess chronic condition prevalence by age, sex, and race/ethnicity, adjusting for the racial/ethnic oversampling.

Results: We observed excess prevalence of most preexisting chronic conditions in beneficiaries with incident epilepsy (n = 20 545, weighted n = 19 631). For stroke, for example, the adjusted prevalence rate ratio (APRR) was 4.82 (99% CI:4.60, 5.04), meaning that, compared to those without epilepsy, beneficiaries with incident epilepsy in 2019 had 4.82 times the stroke prevalence. Similarly, beneficiaries with incident epilepsy had a higher prevalence rate for preexisting neurological conditions (APRR = 3.17, 99% CI = 3.08-3.27), substance use disorders (APRR = 3.00, 99% CI = 2.81-3.19), and psychiatric disorders (APRR = 1.98, 99% CI = 1.94-2.01). For most documented chronic conditions, excess prevalence among beneficiaries with incident epilepsy in 2019 was larger for younger age groups compared to older age groups, and for Hispanic beneficiaries compared to both non-Hispanic White and non-Hispanic Black beneficiaries.

Significance: Compared to epilepsy-free Medicare beneficiaries, those with incident epilepsy in 2019 had a higher prevalence of most preexisting chronic conditions. Our findings highlight the importance of health promotion and prevention, multidisciplinary care, and elucidating shared pathophysiology to identify opportunities for prevention.

Titel:	Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy.
Autor/in / Beteiligte Person:	Koroukian, SM ; Fein, HL ; Vu, L ; Bensken, WP ; Schiltz, NK ; Sajatovic, M ; Ghearing, GR ; Warner, DF
Link:	Zum Volltext
Zeitschrift:	Epilepsia, 2024-06-04
Veröffentlichung:	Ahead of Print, 2024
Medientyp:	academicJournal
ISSN:	1528-1167 (electronic)
DOI:	10.1111/epi.18032
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Epilepsia] 2024 Jun 04. <i>Date of Electronic Publication: </i>2024 Jun 04. References: Sen A, Jette N, Husain M, Sander JW. Epilepsy in older people. Lancet. 2020;395(10225):735–748. ; Vespa J, Armstrong DM, Medinal L. Demographic turning points for the United States: population projections for 2020 to 2060. Current population reports, P25‐1144. Washington, D.C.: U.S. Census Bureau; 2020. ; Hawker GA, King LK. The burden of osteoarthritis in older adults. Clin Geriatr Med. 2022;38(2):181–192. https://doi.org/10.1016/j.cger.2021.11.005. ; Denton FT, Spencer BG. Chronic health conditions: changing prevalence in an aging population and some implications for the delivery of health care services. Can J Aging. 2010;29(1):11–21. https://doi.org/10.1017/S0714980809990390. ; Salive ME. Multimorbidity in older adults. Epidemiol Rev. 2013;35:75–83. https://doi.org/10.1093/epirev/mxs009. ; Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia. 1993;34(3):453–458. https://doi.org/10.1111/j.1528‐1157.1993.tb02586.x. ; Choi H, Pack A, Elkind MS, Longstreth WT Jr, Ton TG, Onchiri F. Predictors of incident epilepsy in older adults: The cardiovascular health study. Neurology. 2017;88(9):870–877. https://doi.org/10.1212/WNL.0000000000003662. ; Lühdorf K, Jensen LK, Plesner AM. Etiology of seizures in the elderly. Epilepsia. 1986;27(4):458–463. https://doi.org/10.1111/j.1528‐1157.1986.tb03567.x. ; Husein N, Josephson CB, Keezer MR. Understanding cardiovascular disease in older adults with epilepsy. Epilepsia. 2021;62(9):2060–2071. https://doi.org/10.1111/epi.16991. ; Elliott JO, Lu B, Shneker B, Charyton C, Layne MJ. Comorbidity, health screening, and quality of life among persons with a history of epilepsy. Epilepsy Behav. 2009;14(1):125–129. https://doi.org/10.1016/j.yebeh.2008.10.013. ; Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol. 2016;15(1):106–115. https://doi.org/10.1016/S1474‐4422(15)00225‐2. ; Weatherburn CJ, Heath CA, Mercer SW, Guthrie B. Physical and mental health comorbidities of epilepsy: Population‐based cross‐sectional analysis of 1.5 million people in Scotland. Seizure. 2017;45:125–131. https://doi.org/10.1016/j.seizure.2016.11.013. ; Rai D, Kerr MP, McManus S, Jordanova V, Lewis G, Brugha TS. Epilepsy and psychiatric comorbidity: a nationally representative population‐based study. Epilepsia. 2012;53(6):1095–1103. https://doi.org/10.1111/j.1528‐1167.2012.03500.x. ; Hesdorffer DC, Hauser WA, Olafsson E, Ludvigsson P, Kjartansson O. Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann Neurol. 2006;59(1):35–41. https://doi.org/10.1002/ana.20685. ; Hesdorffer DC, Ludvigsson P, Olafsson E, Gudmundsson G, Kjartansson O, Hauser WA. ADHD as a risk factor for incident unprovoked seizures and epilepsy in children. Arch Gen Psychiatry. 2004;61(7):731–736. https://doi.org/10.1001/archpsyc.61.7.731. ; Kanner AM, Saporta AS, Kim DH, et al. Mood and Anxiety Disorders and Suicidality in Patients With Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity. Neurology. 2023;100(11):e1123–e1134. https://doi.org/10.1212/WNL.0000000000201671. ; Ottman R, Lipton RB, Ettinger AB, Cramer JA, Reed ML, Morrison A, et al. Comorbidities of epilepsy: results from the epilepsy comorbidities and health (EPIC) survey. Epilepsia. 2011;52(2):308–315. https://doi.org/10.1111/j.1528‐1167.2010.02927.x. ; Stefanidou M, Himali JJ, Devinsky O, Romero JR, Ikram MA, Beiser AS, et al. Vascular risk factors as predictors of epilepsy in older age: the Framingham heart study. Epilepsia. 2022;63(1):237–243. https://doi.org/10.1111/epi.17108. ; Johnson EL, Krauss GL, Lee AK, Schneider ALC, Dearborn JL, Kucharska‐Newton AM, et al. Association between midlife risk factors and late‐onset epilepsy: results from the atherosclerosis risk in communities study. JAMA Neurol. 2018;75(11):1375–1382. https://doi.org/10.1001/jamaneurol.2018.1935. ; Stefanidou M, Das RR, Beiser AS, et al. Incidence of seizures following initial ischemic stroke in a community‐based cohort: the Framingham heart study. Seizure. 2017;47:105–110. https://doi.org/10.1016/j.seizure.2017.03.009. ; Martin RC, Faught E, Richman J, Funkhouser E, Kim Y, Clements K, et al. Psychiatric and neurologic risk factors for incident cases of new‐onset epilepsy in older adults: data from U.S. Medicare beneficiaries. Epilepsia. 2014;55(7):1120–1127. https://doi.org/10.1111/epi.12649. ; Josephson CB, Lowerison M, Vallerand I, Sajobi TT, Patten S, Jette N, et al. Association of Depression and Treated Depression with Epilepsy and seizure outcomes: a multicohort analysis. JAMA Neurol. 2017;74(5):533–539. https://doi.org/10.1001/jamaneurol.2016.5042. ; Jacob L, Bohlken J, Schmitz B, Kostev K. Incidence of epilepsy and associated factors in elderly patients in Germany. Epilepsy Behav. 2019;90:107–111. https://doi.org/10.1016/j.yebeh.2018.10.035. ; Pugh MJ, Knoefel JE, Mortensen EM, Amuan ME, Berlowitz DR, Van Cott AC. New‐onset epilepsy risk factors in older veterans. J Am Geriatr Soc. 2009;57(2):237–242. https://doi.org/10.1111/j.1532‐5415.2008.02124.x. ; Bakaki PM, Koroukian SM, Jackson LW, Albert JM, Kaiboriboon K. Defining incident cases of epilepsy in administrative data. Epilepsy Res. 2013;106(1–2):273–279. https://doi.org/10.1016/j.eplepsyres.2013.05.005. ; Kaiboriboon K, Bakaki PM, Lhatoo SD, Koroukian S. Incidence and prevalence of treated epilepsy among poor health and low‐income Americans. Neurology. 2013;80(21):1942–1949. https://doi.org/10.1212/wnl.0b013e318293e1b4. ; Faught E, Richman J, Martin R, et al. Incidence and prevalence of epilepsy among older U.S. Medicare beneficiaries. Neurology. 2012;78(7):448–453. https://doi.org/10.1212/wnl.0b013e3182477edc. ; Chronic conditions data warehouse. Data Dictionaries. 2023. https://www2.ccwdata.org/web/guest/data‐dictionaries. Accessed 8 Nov 2023. ; Smith JR, Jones FJS, Fureman BE, Buchhalter JR, Herman ST, Ayub N, et al. Accuracy of ICD‐10‐CM claims‐based definitions for epilepsy and seizure type. Epilepsy Res. 2020;166:106414. https://doi.org/10.1016/j.eplepsyres.2020.106414. ; Jarrín OF, Nyandege AN, Grafova IB, Dong X, Lin H. Validity of race and ethnicity codes in Medicare administrative data compared with gold‐standard self‐reported race collected during routine home health care visits. Med Care. 2020;58(1):e1–e8. https://doi.org/10.1097/mlr.0000000000001216. ; StataCorp LLC. Stata statistical software: release 17. College Station: StataCorp LLC; 2021. ; Weeks WB, Cao SY, Smith J, Wang H, Weinstein JN. Trends in characteristics of adults enrolled in traditional fee‐for‐service Medicare and Medicare advantage, 2011–2019. Med Care. 2022;60(3):227–231. ; Bancks MP, Kershaw K, Carson AP, Gordon‐Larsen P, Schreiner PJ, Carnethon MR. Association of modifiable risk factors in young adulthood with racial disparity in incident type 2 diabetes during middle adulthood. JAMA. 2017;318(24):2457–2465. https://doi.org/10.1001/jama.2017.19546. ; Edelman DJ, Gao Q, Mosca L. Predictors and barriers to timely medical follow‐up after cardiovascular disease risk factor screening according to race/ethnicity. J Natl Med Assoc. 2008;100(5):534–539. https://doi.org/10.1016/s0027‐9684(15)31299‐2. ; Castellanos LR, Viramontes O, Bains NK, Zepeda IA. Disparities in cardiac rehabilitation among individuals from racial and ethnic groups and rural communities‐a systematic review. J Racial Ethn Health Disparities. 2019;6(1):1–11. https://doi.org/10.1007/s40615‐018‐0478‐x. ; Wei MY, Leis AM, Vasilyev A, Kang AJ. Development and validation of new multimorbidity‐weighted index for ICD‐10‐coded electronic health record and claims data: an observational study. BMJ Open. 2024;14(2):e074390. https://doi.org/10.1136/bmjopen‐2023‐074390. ; Naylor J, Churilov L, Johnstone B, Guo R, Xiong Y, Koome M, et al. The association between atrial fibrillation and Poststroke seizures is influenced by ethnicity and environmental factors. J Stroke Cerebrovasc Dis. 2018;27(10):2755–2760. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.05.044. ; Szaflarski M. Social determinants of health in epilepsy. Epilepsy Behav. 2014;41:283–289. https://doi.org/10.1016/j.yebeh.2014.06.013. ; Nunes PT, Kipp BT, Reitz NL, Savage LM. Aging with alcohol‐related brain damage: critical brain circuits associated with cognitive dysfunction. In: Deak T, Savage LM, editors. International Review of Neurobiology. London: Academic Press; 2019. p. 101–168:Chap 4. ; Buonacera A, Stancanelli B, Malatino L. Stroke and hypertension: an appraisal from pathophysiology to clinical practice. Curr Vasc Pharmacol. 2019;17(1):72–84. https://doi.org/10.2174/1570161115666171116151051. ; Doria JW, Forgacs PB. Incidence, implications, and management of seizures following ischemic and hemorrhagic stroke. Curr Neurol Neurosci Rep. 2019;19(7):37. https://doi.org/10.1007/s11910‐019‐0957‐4. ; Feyissa AM, Hasan TF, Meschia JF. Stroke‐related epilepsy. Eur J Neurol. 2019;26(1):13813. https://doi.org/10.1111/ene.13813. ; Ip Q, Malone DC, Chong J, Harris RB, Labiner DM. An update on the prevalence and incidence of epilepsy among older adults. Epilepsy Res. 2018;139:107–112. https://doi.org/10.1016/j.eplepsyres.2017.11.022. ; Reid AY, St Germaine‐Smith C, Liu M, et al. Development and validation of a case definition for epilepsy for use with administrative health data. Epilepsy Res. 2012;102(3):173–179. https://doi.org/10.1016/j.eplepsyres.2012.05.009. ; Fonferko‐Shadrach B, Lacey AS, White CP, Powell HWR, Sawhney IMS, Lyons RA, et al. Validating epilepsy diagnoses in routinely collected data. Seizure. 2017;52:195–198. https://doi.org/10.1016/j.seizure.2017.10.008. ; Tian N, Kobau R, Friedman D, Liu Y, Eke PI, Greenlund KJ. Mortality and mortality disparities among people with epilepsy in the United States, 2011–2021. Epilepsy Behav. 2024;155:109770. https://doi.org/10.1016/j.yebeh.2024.109770. ; Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA. Causes and consequences of comorbidity: a review. J Clin Epidemiol. 2001;54(7):661–674. https://doi.org/10.1016/s0895‐4356(00)00363‐2. ; Ivanova JI, Birnbaum HG, Kidolezi Y, Qiu Y, Mallett D, Caleo S. Economic burden of epilepsy among the privately insured in the US. PharmacoEconomics. 2010;28(8):675–685. https://doi.org/10.2165/11535570‐000000000‐00000. Grant Information: U48 DP006404-03S7 United States CC CDC HHS Contributed Indexing: Keywords: Medicare beneficiaries; excess prevalence of chronic conditions; incident epilepsy Entry Date(s): Date Created: 20240605 Latest Revision: 20240605 Update Code: 20240606

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy.