Epilepsy may raise risk of dementia before age 65, study finds

Epilepsy may raise risk of dementia before age 65, study finds

Epilepsy is a chronic neurological disorder characterised by recurrent, unprovoked seizures. A seizure occurs when a sudden burst of abnormal electrical activity in the brain temporarily disrupts its normal functioning.

People living with epilepsy may be more likely to develop dementia before the age of 65, according to new research that highlights the importance of monitoring changes in memory and thinking among people with the neurological condition.

The study, published in Neurology, found that people newly diagnosed with epilepsy had six times the risk of developing young-onset dementia compared with those without epilepsy. Those who had already been diagnosed with epilepsy also faced an increased risk, although it was lower.

However, the researchers cautioned that the findings do not prove epilepsy directly causes dementia. The results show an association between the two conditions, but further research is needed to understand why they occur together.

Epilepsy is a chronic neurological disorder characterised by recurrent, unprovoked seizures. A seizure occurs when a sudden burst of abnormal electrical activity in the brain temporarily disrupts its normal functioning. Depending on the area involved, seizures may cause a person to lose awareness, experience uncontrolled movements, stare blankly for a short period or notice unusual sensations.

Epilepsy can affect people of any age, and its causes vary. In some cases, it develops following a brain injury, stroke, brain infection or a condition that affects brain development. Other possible causes include brain tumours and certain genetic conditions. However, many people with epilepsy do not have a clearly identified cause.

Having a risk factor does not necessarily mean someone will develop epilepsy. Factors that may increase the risk include a family history of the condition, serious head injuries, stroke, infections affecting the brain such as meningitis or encephalitis, and certain complications that cause brain damage before or around birth. In some people, epilepsy develops without any known risk factor.

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Epilepsy is not contagious, and having a seizure does not automatically mean a person has the condition. Seizures can sometimes occur because of other problems, including very low blood sugar, certain infections or alcohol withdrawal. A medical assessment is needed to establish the cause and determine whether a person has epilepsy.

Dementia, meanwhile, affects memory, thinking, language and the ability to manage everyday activities. Although it is more common in older adults, young-onset dementia can affect people during their working and family-raising years, sometimes disrupting their independence and quality of life.

Previous studies have linked epilepsy to dementia that develops later in life, but there has been less evidence on its relationship with dementia occurring before the age of 65.

To investigate the connection, researchers analysed national health databases in France and Sweden. They compared people diagnosed with young-onset dementia with others of similar age and sex who did not have dementia, looking for previous epilepsy diagnoses and records of epilepsy medication use.

In France, the analysis included 11,360 people with young-onset dementia and 113,600 people without the condition. In Sweden, researchers examined 16,433 people with dementia and 164,330 people without it.

The results showed that 12.5 per cent of people with young-onset dementia had previously been diagnosed with epilepsy, compared with 1.2 per cent of those without dementia.

The use of epilepsy medication was also more common among people with dementia. About 27.3 per cent of those with young-onset dementia had records of epilepsy medication use, compared with 10.3 per cent of people without dementia. Similar patterns were observed in Sweden.

Researchers also examined whether people with epilepsy were more likely to develop dementia over time. This part of the study followed three groups in France for up to 10 years: 12,901 people newly diagnosed with epilepsy, 64,083 people who already had the condition, and 129,010 people without epilepsy.

During the follow-up period, 2.2 per cent of those newly diagnosed with epilepsy developed young-onset dementia. The proportion was 1.7 per cent among people with existing epilepsy and 0.2 per cent among those without the condition.

After accounting for other factors that could influence dementia risk, including stroke, mood disorders and traumatic brain injury, researchers found that people newly diagnosed with epilepsy had six times the risk of developing young-onset dementia. Those with an existing diagnosis had a 74 per cent higher risk than people without epilepsy.

The findings suggest that people with epilepsy may benefit from closer attention to their cognitive health, particularly if they experience persistent changes in memory, concentration or their ability to carry out daily tasks.

“Previous studies have shown a link between epilepsy and late-onset dementia, but limited evidence was available about young-onset dementia,” the researchers noted.

They said the findings support incorporating dementia prevention into epilepsy care, including assessing patients’ cognitive health and managing modifiable risk factors. These include cardiovascular risks such as high blood pressure.

The research also had limitations. Researchers lacked detailed information about the specific types and causes of dementia, as well as the types of epilepsy experienced by participants. As a result, the study could not establish whether particular forms of epilepsy were more strongly associated with dementia.

The findings were based on health records from France and Sweden, both high-income countries with broad healthcare coverage. The results may not fully reflect experiences in countries where access to neurological services, diagnosis and long-term care is more limited.

The researchers said further studies are needed to explain the relationship between epilepsy and young-onset dementia, identify people who may be at greater risk, and determine whether managing modifiable health factors could help reduce that risk.

Epilepsy affects more than 50 million people globally, according to the World Health Organisation (WHO), which estimates that up to 70 per cent of people with the condition could become seizure-free with appropriate treatment.