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Rates of Depression in Older Adults With Epilepsy

November 29, 2017

According to authors Rebecca O’Dwyer (Rush University Medical Center, Rush Epilepsy Center) and coauthors, approximately 25% of all patients with epilepsy are aged 60 years or older and as the population ages, some predict that half of all newly diagnosed with epilepsy will be older than 65 years by 2020. Higher rates of depression have been associated with other conditions such as stroke, cardiovascular disease, Parkinson disease, and dementia, yet little is known about rates of depression in older adults with epilepsy.

Presenters analyzed patient data of all patients seen at the Rush Epilepsy Clinic between 2014-2016 to better understand the rates of depression in older adults with epilepsy. Demographic data, neuroimaging, electroencephalographic data and clinical data [including scores on the Neurological Disorders Depression Inventory for Epilepsy screen (NDDI-E) and Patient Health Questionnaire – General Anxiety Disorder screens (PHQ-GAD – 7) that were administered during the outpatient visit] were obtained as measurements for depression, anxiety and risk for suicide respectively.

So far in the study, 73 patients, > age 60 years, have been identified (40 females). The average score on the NDDI-E was 11+/- 4 (> 10 is diagnostic for depression), on the PHQ-GAD-7 was 5 +/- 5 (>15 is diagnostic for anxiety). Fifty-two percent (n = 38) scored positive for depression, while only five percent (n=4) scored positive for anxiety.

Presenters summarized their findings thus far: “Approximately 17%-30% of patients will meet formal criteria for major depressive disorder and 21% of patients with poorly controlled temporal lobe epilepsy will have major anxiety disorder. Higher rates (20%-60%) of depression are associated with intractable epilepsy, however our patients were not intractable and had a higher than expected rate of depression (52%) but did not suffer from anxiety (5%). While advanced age in this older cohort was not associated with depression, duration of epilepsy appeared to have an effect.”

Overall, the authors felt that the depression rates in this cohort seem “significantly higher than expected” and plan to investigate these results further. (Abstract 3.245)

—Amanda Del Signore

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