Racial/ethnic differences in the association of incident stroke with late onset epilepsy: The Northern Manhattan Study.

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY

Epilepsia Pub Date : 2024-10-15 DOI:10.1111/epi.18156

Hyunmi Choi, Evan L Thacker, Minghua Liu, Kevin Strobino, Sylwia Misiewicz, Tatjana Rundek, Mitchell S V Elkind, Jose D Gutierrez

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引用次数: 0

Abstract

Objective: Little is known about the incidence of late onset epilepsy (LOE) across different racial/ethnic groups in the USA, particularly in the Hispanic population. Stroke, a strong predictor of LOE, is more common in non-Hispanic Blacks (NHBs) and Hispanics than in non-Hispanic Whites (NHWs). We assessed the incidence of LOE across racial/ethnic groups and examined whether the associations of stroke with LOE risk differ by race/ethnicity.

Methods: The Northern Manhattan Study is a population-based longitudinal study of older adults enrolled between 1993 and 2001. Participants free of history of stroke or epilepsy at baseline (n = 3419) were followed prospectively for incidence of LOE. We estimated LOE incidence per 1000 person-years in each racial/ethnic group. We used Cox proportional hazards regression to assess the association of race/ethnicity with LOE and multiplicative interactions of race/ethnicity with incident stroke in relation to LOE, adjusting for demographics and comorbid diagnoses.

Results: During 51 176 person-years of follow-up, 183 individuals developed LOE. Incidence of LOE was significantly higher in NHBs (6.2 per 1000 person-years) than in NHWs (3.3 per 1000 person-years, p = .004). There was no significant difference in LOE incidence between NHWs (3.3 per 1000 person-years) and Hispanics (2.6 per 1000 person-years, p = .875). However, following incident stroke, the risk of LOE differed across racial/ethnic groups. Incident stroke was associated with 2.55 times the risk of LOE among NHWs (95% confidence interval [CI] = .88-7.35), 8.53 times the risk of LOE among Hispanics (95% CI = 5.36-13.57, p = .04 for stronger association than that in NHWs), and 6.46 times the risk of LOE among NHBs (95% CI = 3.79-11.01, p = .12 for stronger association than that in NHWs).

Significance: We found a stronger association of incident stroke with LOE risk in Hispanics and NHBs than in NHWs, offering some insight into the racial/ethnic disparities of LOE incidence.

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中风事件与晚发性癫痫之间的种族/民族差异：北曼哈顿研究

目的：人们对美国不同种族/族裔群体的晚发性癫痫（LOE）发病率知之甚少，尤其是在西班牙裔人群中。脑卒中是预测晚发性癫痫的一个重要因素，在非西班牙裔黑人（NHBs）和西班牙裔人群中比在非西班牙裔白人（NHWs）中更为常见。我们评估了不同种族/族裔群体 LOE 的发病率，并研究了中风与 LOE 风险的关联是否因种族/族裔而异：北曼哈顿研究是一项基于人群的纵向研究，研究对象为 1993 年至 2001 年间入组的老年人。对基线时无中风或癫痫病史的参与者（n = 3419）进行了前瞻性随访，以了解 LOE 的发病率。我们估算了每个种族/人种组每千人年的 LOE 发生率。我们使用 Cox 比例危险回归评估了种族/民族与 LOE 的关系，以及种族/民族与中风事件的乘法交互作用与 LOE 的关系，并对人口统计学和合并症诊断进行了调整：在 51176 人年的随访中，183 人发生了 LOE。非裔美国人的 LOE 发生率（每 1000 人年 6.2 例）明显高于非裔美国人（每 1000 人年 3.3 例，p = .004）。非白种人（每千人年 3.3 例）和西班牙裔人（每千人年 2.6 例，p = .875）的 LOE 发生率无明显差异。然而，在发生卒中后，不同种族/族裔群体的 LOE 风险有所不同。NHWs（95% 置信区间 [CI] = .88-7.35）、西班牙裔（95% 置信区间 [CI] = 5.36-13.57，p = .04 表示与 NHWs 的关联性更强）和 NHBs（95% 置信区间 [CI] = 3.79-11.01，p = .12 表示与 NHWs 的关联性更强）的 LOE 风险分别为 2.55 倍、8.53 倍和 6.46 倍：我们发现西班牙裔和 NHBs 中发生卒中与 LOE 风险的关系比 NHWs 更密切，这为 LOE 发生率的种族/民族差异提供了一些启示。

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.