Incidence and predictors of seizures in patients with Alzheimer's disease

Joan C. Amatniek, W. Allen Hauser, Carrie DelCastillo-Castaneda, Diane M. Jacobs, Karen Marder, Karen Bell, Marilyn Albert, Joseph Brandt, Yaakov Stern

Research output: Contribution to journalArticle

Abstract

Purpose: To determine cumulative incidence and predictors of new-onset seizures in mild Alzheimer's disease (AD) with a cohort followed prospectively. Limited information is available on the incidence of seizures, and no reports exist of seizure predictors in AD patients. Methods: Mild AD patients were prospectively followed at 6-month intervals to estimate incidence of unprovoked seizures, compare age-specific risk of unprovoked seizures with population norms, and identify characteristics at baseline (demographics, duration and severity of AD, physical and diagnostic test findings, and comorbid medical and psychiatric conditions) influencing unprovoked seizure risk. Review of study charts and medical records supplemented coded end-point data. Results: The cumulative incidence of unprovoked seizures at 7 years was nearly 8%. In all age groups, risk was increased compared with a standard population, with an 87-fold increase in the youngest group (age 50-59 years) and more than a three-fold increase in the oldest group (age 85+ years). In multivariate modeling, independent predictors of unprovoked seizures were younger age [relative risk (RR), 0.89 per year increase in age; 95% confidence interval (CI), 0.82-0.97], African-American ethnic background (RR, 7.35; 95% CI, 1.42-37.98), more-severe dementia (RR, 4.15; 95% CI, 1.06-16.27), and focal epileptiform findings on electroencephalogram (EEG) (RR, 73.36; 95% CI, 1.75-3075.25). Conclusions: Seizure incidence is increased in people starting with mild-to-moderate AD. Younger individuals, African Americans, and those with more-severe disease or focal epileptiform findings on EEG were more likely to have unprovoked seizures.

Original languageEnglish (US)
Pages (from-to)867-872
Number of pages6
JournalEpilepsia
Volume47
Issue number5
DOIs
StatePublished - May 1 2006

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Keywords

  • Alzheimer's disease
  • Cumulative incidence
  • Predictors
  • Prospective cohort
  • Seizures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Amatniek, J. C., Hauser, W. A., DelCastillo-Castaneda, C., Jacobs, D. M., Marder, K., Bell, K., Albert, M., Brandt, J., & Stern, Y. (2006). Incidence and predictors of seizures in patients with Alzheimer's disease. Epilepsia, 47(5), 867-872. https://doi.org/10.1111/j.1528-1167.2006.00554.x