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

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY

Epilepsia Pub Date : 2024-06-04 DOI:10.1111/epi.18032

Siran M. Koroukian, Hannah L. Fein, Long Vu, Wyatt P. Bensken, Nicholas K. Schiltz, Martha Sajatovic, Gena R. Ghearing, David F. Warner

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引用次数: 0

Abstract

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.

Abstract Image

查看原文本刊更多论文

患有癫痫的老年人原有慢性病患病率过高。

目的：先前的研究已对患有流行性癫痫的老年人的慢性病进行了检查，但很少对偶发性癫痫患者的慢性病进行检查。确定老年人癫痫发病时的慢性病有助于评估这一患者群体的疾病负担，并为协调护理的发展提供信息。本研究的目的是确定与未患癫痫的老年人相比，患癫痫的老年人发病率较高的原有慢性疾病：我们使用 4999999 名年龄大于 65 岁的付费医疗保险受益人的随机样本，对 2019 年的癫痫发病率进行了回顾性队列研究。非西班牙裔黑人和西班牙裔受益人被超量抽样。我们从 2016-2018 年医疗保险受益人摘要档案中确定了既往慢性病，并比较了 2019 年有癫痫和无癫痫的医疗保险受益人之间的慢性病患病率。我们按年龄、性别和种族/民族对已有的超常慢性病患病率的变化进行了描述，并对种族/民族超常抽样进行了调整：我们观察到大多数已有慢性病在癫痫事件受益人中的超常患病率（n = 20 545，加权 n = 19 631）。以中风为例，调整后患病率比（APRR）为 4.82（99% CI：4.60, 5.04），这意味着与没有癫痫的受益人相比，2019 年患有癫痫的受益人的中风患病率是后者的 4.82 倍。同样，患有癫痫的受益人在原有神经系统疾病（APRR = 3.17，99% CI = 3.08-3.27）、药物使用障碍（APRR = 3.00，99% CI = 2.81-3.19）和精神障碍（APRR = 1.98，99% CI = 1.94-2.01）方面的患病率也较高。就大多数记录在案的慢性病而言，2019 年发生癫痫的受益人中，年轻年龄组的患病率高于老年年龄组，西班牙裔受益人的患病率高于非西班牙裔白人和非西班牙裔黑人受益人：与无癫痫的医疗保险受益人相比，2019 年发生癫痫的受益人患有大多数既往慢性病的比例更高。我们的研究结果凸显了健康促进和预防、多学科护理以及阐明共同病理生理学以确定预防机会的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsia 医学-临床神经学

CiteScore

10.90

自引率

10.70%

发文量

319

审稿时长

2-4 weeks

期刊介绍： Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.