Association of epilepsy with trajectory of depressive symptoms in late life: The Cardiovascular Health Study.

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY

Epilepsia Pub Date : 2025-08-01 DOI:10.1111/epi.18579

Hyunmi Choi, Brenna Stepan, Rya Clifton, W T Longstreth, Mitchell S V Elkind, Jose Gutierrez, Evan L Thacker

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引用次数: 0

Abstract

Objectives: Although depression is one of the most common psychiatric comorbidities among individuals with epilepsy, data specific to older adults with epilepsy are scarce. We examined the trajectory of depressive symptom scores in older adults with and without epilepsy.

Methods: The Cardiovascular Health Study is a population-based longitudinal cohort of U.S. adults 65 years of age or older. Depression scores were measured annually using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) for up to 9 years of follow-up. We used a linear mixed model to estimate mean CESD-10 scores and percent with depression (CESD-10 score ≥10) over time by epilepsy status, adjusted for demographics, health behaviors, clinical characteristics, and measures of life satisfaction.

Results: CESD-10 scores increased at a significantly faster rate over 9 years among older adults with epilepsy (n = 190; 2.8 points) compared to those without epilepsy (n = 5264; 1.8 points; p = 0.005), adjusted for the covariates specified above. The proportion of those who met the threshold for depression also increased at a significantly faster rate among older adults with epilepsy compared to those without epilepsy. The proportion with depression increased by 19.8 cases per 100 (95% confidence interval [CI]: 12.9-26.6) in older adults with epilepsy, compared to an increase of 10.2 cases per 100 (95% CI: 9.0-11.4) in those without epilepsy (a difference in the increase of 9.6 additional cases per 100 [95% CI: 2.7-16.5]; p = 0.007), adjusted for covariates. The association of epilepsy with CESD-10 score trajectory did not differ by sex.

Significance: Older adults with epilepsy experience worse depressive symptom trajectories over time compared to older adults without epilepsy, with one in five individuals experiencing depression over 9 years. These findings highlight the need for systematic and repeated screening of depression in older adults with epilepsy.

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癫痫与晚年抑郁症状轨迹的关联：心血管健康研究

目的：虽然抑郁症是癫痫患者中最常见的精神合并症之一，但针对老年癫痫患者的数据很少。我们检查了有和没有癫痫的老年人抑郁症状评分的轨迹。方法：心血管健康研究是一项以人群为基础的美国65岁及以上成年人纵向队列研究。在长达9年的随访中，每年使用10项流行病学研究中心抑郁量表（csd -10）测量抑郁评分。我们使用线性混合模型来估计癫痫状态随时间推移的平均csd -10评分和抑郁症（csd -10评分≥10）的百分比，并根据人口统计学、健康行为、临床特征和生活满意度进行调整。结果：老年癫痫患者的csd -10评分在9年内以更快的速度增加(n = 190；2.8分)与非癫痫患者相比(n = 5264；1.8分;P = 0.005)，根据上述协变量进行调整。与没有癫痫的老年人相比，患有癫痫的老年人达到抑郁阈值的比例也以明显更快的速度增加。在老年癫痫患者中，抑郁症患者的比例每100例增加19.8例（95%可信区间[CI]: 12.9-26.6），而在无癫痫患者中，抑郁症患者的比例每100例增加10.2例（95% CI: 9.0-11.4）(差异为每100例增加9.6例[95% CI: 2.7-16.5]；P = 0.007)，校正协变量。癫痫与csd -10评分轨迹的关系无性别差异。意义：与没有癫痫的老年人相比，老年癫痫患者随着时间的推移会经历更严重的抑郁症状轨迹，五分之一的人在9年内经历抑郁。这些发现强调需要对老年癫痫患者进行系统和反复的抑郁筛查。

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.