Neuroscience Research Australia, Sydney, New South Wales, Australia.
School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia.
J Am Geriatr Soc. 2021 Jul;69(7):2011-2020. doi: 10.1111/jgs.17101. Epub 2021 Mar 19.
BACKGROUND/OBJECTIVES: Coexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics.
A systematic review and meta-analysis (PROSPERO protocol registration CRD42020150479).
Population-, community-, hospital-, or nursing home-based.
Thirty-nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I ) were not shown, rates were synthesized using random effect.
Studies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person-years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early-onset AD) in one study. Meta-analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14-19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult-onset seizures had AD (95%CI, 7-14).
Seizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.
背景/目的：并存的癫痫发作给阿尔茨海默病（AD）的负担增加了复杂性。我们旨在估计并存癫痫发作和 AD 的发病率和患病率，并总结其特征。
系统评价和荟萃分析（PROSPERO 方案注册 CRD42020150479）。
人群、社区、医院或疗养院。
39 项研究报告了分别在 21198 名和 380777 名 AD 患者中发生癫痫的发病率和患病率，以及在 727446 名癫痫患者中 AD 的患病率。当未显示统计异质性和不一致性（通过 Q 统计量和 I 评估）时，使用随机效应合成速率。
研究在澳大利亚、巴西、芬兰、法国、爱尔兰、意大利、日本、荷兰、葡萄牙、瑞典、中国台湾、英国和美国进行。在临床诊断为 AD 的人群中，癫痫发作的发病率在每 1000 人年 4.2 至 31.5 例之间。在临床诊断为 AD 的人群中，癫痫发作的患病率通常在 1.5%至 12.7%之间，但在一项研究中，患病率最高（早发性 AD 患者的 49.5%）。荟萃分析报告，经病理证实的 AD 患者中癫痫发作的总患病率为 16%（95%置信区间 [CI] 14-19）。常染色体显性遗传 AD（ADAD）中癫痫发作的患病率为 2.8%至 41.7%。年龄较小与癫痫发作风险较高相关。11%的成年发作患者患有 AD（95%CI，7-14）。
癫痫在 AD 患者中很常见，癫痫监测对于年轻成年人和 ADAD 患者可能尤为重要。
