Department of Neurology, the second affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, Fujian 362000, PR China.
Department of Spine Surgery, the second affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, Fujian 362000, PR China.
Clin Neurol Neurosurg. 2022 Dec;223:107499. doi: 10.1016/j.clineuro.2022.107499. Epub 2022 Oct 29.
Although available literature indicates a high risk of dementia in elderly patients with late-onset epilepsy (LOE), the findings are yet inconsistent and relevant risk factors are unclear, rendering rational clinical interpretation rather challenging. This article systematically evaluates the risk of dementia in elderly LOE patients. The potential risk factors were analyzed to provide a specific basis for clinical prediction of dementia. PubMed and web of science databases were searched for the published cohort studies of dementia in elderly LOE patients. The search results were subject to a meta-analysis with Stata16.0 statistical software. Seven articles were included for a comparison of dementia risk between epilepsy cases and controls, yielding a hazard ration (HR) of 2.1 (95 %CI:1.6~2.75,p = 0.00); dementia was more prevalent in female patients than in male counterparts, though without a statistical difference [1.2 % (95 %CI, 0.9 %-1.6 %) vs. 0.8 % (95 %CI, 0.5 %-1.1 %)]; compared with the non-LOE group, the LOE population reported a significantly higher incidence of diabetes mellitus [14.1 % (95 %CI, 12.8 %-15.4 %) vs. 10.9 % (95 %CI, 10.1 %-11 %), p < 0.01]. The findings suggest that elderly patients with late-onset epilepsy run a higher risk of dementia than non-epileptic patients and diabetes mellitus may serve as a potential risk factor for dementia in this elderly populace.
尽管现有文献表明,老年晚发性癫痫(LOE)患者痴呆风险较高,但研究结果尚不一致,相关风险因素也不明确,这使得合理的临床解释颇具挑战性。本文系统评估了老年 LOE 患者发生痴呆的风险。分析潜在的危险因素,为痴呆的临床预测提供具体依据。检索PubMed 和 web of science 数据库中关于老年 LOE 患者痴呆的队列研究文献。采用 Stata16.0 统计软件进行荟萃分析。纳入 7 篇比较癫痫组和对照组痴呆风险的文章,得出癫痫组痴呆风险的危险比(HR)为 2.1(95%CI:1.6~2.75,p=0.00);女性患者痴呆的发生率高于男性,但差异无统计学意义[1.2%(95%CI,0.9%~1.6%)比 0.8%(95%CI,0.5%~1.1%)];与非 LOE 组相比,LOE 人群报告糖尿病的发生率明显更高[14.1%(95%CI,12.8%~15.4%)比 10.9%(95%CI,10.1%~11%),p<0.01]。结果表明,老年 LOE 患者发生痴呆的风险高于非癫痫患者,糖尿病可能是老年人群发生痴呆的潜在危险因素。