Jeongyeon Hwang1, Maryam Syed1, Deepti Zutshi1, Rohit Marawar1
1Department of Neurology, Detroit Medical Center/Wayne State University School of Medicine
Objective:
The objective of study was to demonstrate the clinical role of anxiety in older adults with epielpsy.
Background:
Anxiety disorders is one of the important comorbidities of epilepsy that increases with advancing age and can have significant impact on patient’s quality of life. However, this has not been well explored in older adults with epilepsy.
Design/Methods:
Patients with epilepsy aged 55 and older were recruited from the epilepsy clinics at the Level IV epilepsy center. Generalized Anxiety Disorder Assessment (GAD-7) and Patient Weighted Quality of Life in Epilepsy (QOLIE-10-P) were conducted to measure anxiety and quality of life respectively. Both are well-established scales in persons with epilepsy.
Results:
A total of 127 older adults with epilepsy (Age 62.0 years, 51% females, 81% African American, and 46.5% GAD-7 positive [score ≥5]) were included in the study. GAD-7 positive group was younger (p=0.003), included more females (p=0.005), more likely to have seizures > 1/month, and had worse quality of life (p<0.001), compared to the GAD-7 negative group. Seizure types, the presence of generalized tonic-clonic seizures, seizure frequency, or anti-epileptic drugs (AEDs) polytherapy were not significantly associated with GAD-7 score, after adjusting age, gender, and ethnicity. However, severe anxiety (GAD-7 score ≥15) was significantly associated with AED polytherapy (β=1.214, p=0.044) and GAD-7 score was significantly associated with QOLIE-10-P score (β=0.759, p<0.001), after considering age and gender.
Conclusions:
Almost half (46.5%) of the older adults with epilepsy screened positive for anxiety using GAD-7. Despite its high expected prevalence, it is under-evaluated and under-diagnosed in older adults. The GAD-7 positive group were more likely to be female, relatively younger, and with seizure frequency > 1/month. Particularly, severe anxiety might be a valuable indicator to predict AED polytherapy in older patients with epilepsy. Moreover, anxiety had a huge impact on the quality of life in older adults with epilepsy.