To study the occurrence of depression in the geriatric epilepsy patient population and associated factors.

Epilepsy in older adults poses a unique set of challenges associated with managing chronic seizures in the setting of disability, cognitive decline, and dependence. Depression is a common comorbidity of epilepsy, and may be under-diagnosed and undertreated 

This cross-sectional study was conducted at the epilepsy outpatient clinic at Wayne State University. Subjects (age ≥ 55 years) with epilepsy were consented to participate in the study with IRB approval. Non-English speakers were excluded. Survey questions included patient demographics, seizure frequency, number of anti-seizure medications (ASM), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Generalized Anxiety Disorder (GAD-7). Descriptive analysis to assess the occurrence of depression, and logistic regression analysis was conducted to find an association of depression with demographic factors while controlling anxiety.

A total of 127 unique epilepsy patients ≥ 55 years old were included, out of whom 49.2% were males, 84% identified as Black persons, 28% were on 2 or more ASMs. Positive depression results (NDDI-E ≥ 15) were present in 23.6% of the patients, 53.3% of whom were females. Average NDDI-E score was 10.7 (±4.4) On the NDDI-E score breakdown, most feelings of depression were related to every day struggling (86%), feeling guilty (76%), feeling frustrated (90%), whereas suicidal ideation was present in six (20%) of patients with depression. Logistic regression of age, gender, race, number of ASMs and seizure frequency did not show a significant relationship when controlled for anxiety.

Depression remains a significant comorbidity in older adults living with epilepsy. Findings of this study underscore the importance of screening for depression and suicidal ideation in this patient population.