Department of Neurology, Siun Sote, North Karelia Central Hospital, Joensuu, Finland.
Clinical Neurosciences, University of Turku, Turku, Finland.
Eur J Neurol. 2022 Feb;29(2):605-608. doi: 10.1111/ene.15141. Epub 2021 Oct 29.
The incidence of epilepsy is decreasing among the working-aged in high-income countries, but previous studies have reported conflicting results in Finland.
A nationwide population-based cross-sectional analysis was made of annual epilepsy drug reimbursement rights frequency data from the Social Insurance Institution of Finland, the national authority, between 1986 and 2019. All persons at least 20 years of age living in Finland during the study period were included.
Based on the analysis of 77,939 new reimbursement rights, crude incidence was 57.4/100,000 (95% confidence interval [CI] = 57.0-57.8) person-years, and age-standardized (to the European Standard Population 2013) incidence was 51.6/100,000 person-years. Both crude (r = 0.62, p = 0.00009) and standardized (r = 0.65, p = 0.00003) incidence increased over time. Incidence increased in both men (from 66.4 to 71.6/100,000, r = 0.51, p = 0.002) and women (from 51.5 to 55.3/100,000, r = 0.68, p < 0.00001). The mean male to female incidence rate ratio was 1.28 (95% CI = 1.26-1.30, range = 1.15-1.41), but decreased during the study period (r = -0.47, p = 0.006). Incidence decreased in those 20-59 years old but increased in all older age groups. This development was similar between sexes.
The incidence of adult onset epilepsy in Finland increased in people older than 60 years and decreased in the 20-59-year age group during the study period. These trends were similar between sexes. Therefore, etiological epilepsy trends in the elderly need to be studied further to plan public health measures to prevent epilepsy in this age group.
在高收入国家，工作年龄段人群的癫痫发病率正在下降，但芬兰此前的研究结果却存在矛盾。
对芬兰国家社会保险局（国家权威机构）1986 年至 2019 年期间的年度癫痫药物报销权数据进行了全国性的基于人群的横断面分析。所有在研究期间居住在芬兰且年龄至少 20 岁的人都被纳入了研究。
基于对 77939 项新报销权的分析，粗发病率为 57.4/100000（95%置信区间[CI] = 57.0-57.8）人年，年龄标准化（至 2013 年欧洲标准人口）发病率为 51.6/100000 人年。粗发病率（r=0.62，p=0.00009）和标准化发病率（r=0.65，p=0.00003）均随时间推移而增加。男性（从 66.4 增至 71.6/100000，r=0.51，p=0.002）和女性（从 51.5 增至 55.3/100000，r=0.68，p<0.00001）的发病率均增加。男性与女性的发病率比值为 1.28（95%CI=1.26-1.30，范围=1.15-1.41），但在研究期间下降（r=-0.47，p=0.006）。20-59 岁人群的发病率下降，但所有较年长年龄组的发病率均增加。这种发展趋势在两性之间相似。
在研究期间，芬兰成年人癫痫的发病率在 60 岁以上人群中增加，在 20-59 岁年龄组中下降。这种趋势在两性之间相似。因此，需要进一步研究老年人癫痫的病因趋势，以制定预防该年龄段人群癫痫的公共卫生措施。
