Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
Epilepsia. 2017 Jun;58(6):962-972. doi: 10.1111/epi.13744. Epub 2017 Apr 11.
Dementia is among the top 15 conditions with the most substantial increase in burden of disease in the past decade, and along with epilepsy, among the top 25 causes of years lived with disability worldwide. The epidemiology of dementia in persons with epilepsy, and vice versa, is not well characterized. The purpose of this systematic review was to examine the prevalence, incidence, and reported risk factors for dementia in epilepsy and epilepsy in dementia.
Embase, PsycINFO, MEDLINE, and the Cochrane databases were searched from inception. Papers were included if they reported the incidence and/or prevalence of dementia and epilepsy. Two individuals independently performed duplicate abstract and full-text review, data extraction, and quality assessment. Random-effects models were used to generate pooled estimates when feasible.
Of the 3,043 citations identified, 64 were reviewed in full text and 19 articles were included. The period prevalence of dementia ranged from 8.1 to 17.5 per 100 persons among persons with epilepsy (insufficient data to pool). The pooled period prevalence of epilepsy among persons with dementia was 5 per 100 persons (95% confidence interval [CI] 1-9) in population-based settings and 4 per 100 persons (95% CI 1-6) in clinic settings. There were insufficient data to report a pooled overall incidence rate and only limited data on risk factors.
There are significant gaps in knowledge regarding the epidemiology of epilepsy in dementia and vice versa. Accurate estimates are needed to inform public health policy and prevention, and to understand health resource needs for these populations.
痴呆症是过去十年中疾病负担增加最多的前 15 种疾病之一，与癫痫一起，也是全世界导致残疾生活年数最多的前 25 种疾病之一。癫痫患者和癫痫患者中痴呆症的流行病学情况尚不清楚。本系统评价的目的是检查癫痫和痴呆症中痴呆症的患病率、发病率和报告的危险因素，以及反之亦然。
从开始时就对 Embase、PsycINFO、MEDLINE 和 Cochrane 数据库进行了搜索。如果论文报告了痴呆症和癫痫的发病率和/或患病率，则将其纳入。两名独立的个体进行了重复的摘要和全文审查、数据提取和质量评估。在可行的情况下，使用随机效应模型生成汇总估计值。
在 3043 条引文中有 64 条进行了全文审查，19 篇文章被纳入。癫痫患者中痴呆症的现患率范围为每 100 人 8.1 至 17.5（数据不足，无法汇总）。在基于人群的环境中，痴呆症患者中癫痫的现患率为每 100 人 5（95%置信区间 1-9），在诊所环境中为每 100 人 4（95%置信区间 1-6）。没有足够的数据报告汇总的总体发病率，并且只有关于危险因素的有限数据。
对于痴呆症和癫痫患者中癫痫的流行病学情况，我们的知识存在重大差距。需要准确的估计值来为公共卫生政策和预防提供信息，并了解这些人群的卫生资源需求。
