Undiagnosed Depression Is Associated with Poor Quality of Life in Older Adults with Epilepsy
Doha Amin1, Maryam Syed2, Rohit Marawar3
1Michigan State University College of Osteopathic Medicine, 2Wayne State University School of Medicine, 3Wayne State University - Detroit Medical Center
Objective:
To identify factors associated with poor quality of life (QoL) in older adults with epilepsy (OAE).
Background:
QoL in OAE is likely affected by seizure frequency, medication burden, and comorbid conditions, including psychiatric disorders such as depression and anxiety. Despite these potential impacts, few studies have specifically evaluated QoL determinants in this population.
Design/Methods:
We retrospectively analyzed prospectively collected data from 76 OAE patients (age ≥55) who completed the Quality of Life in Epilepsy-10-P (QOLIE-10-P) questionnaire at a multidisciplinary Geriatric Epilepsy Clinic between 2019 and 2023. Data included demographics, epilepsy characteristics, emergency department visits, hospitalizations, number of antiseizure medications (ASMs) and other medications, medical and psychiatric comorbidities, and scores from the Generalized Anxiety Disorder-7 (GAD-7), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and AD8 Dementia Screening Interview. The GAD-7 and NDDI-E were administered to patients without prior diagnoses of anxiety or depression, respectively, and the AD8 to those without known cognitive impairment. Poor QoL was defined as a QOLIE-10-P score >30.5. Associations were assessed using Pearson χ² tests; variables with p < 0.1 were included in multivariate logistic regression models. p-value < 0.05 was considered significant.
Results:
Among the 76 patients (median age 63, range 55–91; 44.7% female; 84.2% Black), poor QoL was identified in 18.4%. Significant factors associated with poor QoL on univariate analysis included taking ≥2 medications (34%), temporal lobe seizure onset (14.5%), moderate to severe anxiety (GAD-7 ≥11; 19.7%), positive cognitive impairment screening (AD8 ≥2; 43.4%), and positive depression screening (NDDI-E ≥15; 18.4%). Multivariate logistic regression showed that NDDI-E score ≥15 was significantly associated with poor QoL (p < 0.015), even after adjusting for other variables.
Conclusions:
An elevated NDDI-E score ≥15, indicating undiagnosed depression, was significantly associated with poor QoL in OAE. Active screening and management of psychiatric comorbidities, particularly depression, are crucial to improving QoL in this population.
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