Hypertension, diabetes and smoking could increase risk of epilepsy in later life

Hypertension, diabetes and smoking do not just precipitate cardiovascular diseases. These lifestyle factors were also associated with onset later in life of epilepsy.

Epilepsy is a a neurological disorder with higher risk in older age. It’s most common symptoms are seizures though epilepsy may in effect present as virtually any involuntary action – including smaller limb or eyelid movements and loss of consciousness.

An observational study by researchers from the Johns Hopkins University in Maryland used data from a large, biracial group of people followed for more than 25 years. They concluded that hypertension, diabetes, smoking, apolipoprotein E 4 allele status (variant of a gene associated with increased risk of developing Alzheimer disease), stroke and dementia were associated with increased risk of epilepsy.

More physical activity and moderate alcohol intake were associated with lower risk.

More physical activity and moderate alcohol intake were associated with lower risk.

The annual incidence of epilepsy is 90 to 150 per 100 000 in elderly populations, higher than at any other time of life, with a prevalence of 1.1% by age 60 years and cumulative incidence of 4.4% by age 85 years.

The researchers concluded: “These findings show that midlife vascular and lifestyle risk factors may contribute to the development of epilepsy later in life. Associations differed somewhat by race/ethnicity, with a greater risk for LOE (late onset epilepsy) in black participants with diabetes.”

The results, they said have a number of important implications. They imply that (as for stroke and cardiovascular disease) it is possible that lifestyle modifications and treatment of earlier-life conditions could mitigate these risk factors. Second, they raise the possibility of identifying patients at risk for LOE who may benefit from clinical trials of targeted interventions for prevention.