Yen Pao-Sheng, Muo Chih-Hsin, Yeh Chung-Hsin, Sung Fung-Chang
Department of Neuroradiology, Kuang Tien General Hospital, Taichun 43303, Taiwan.
Department of Nursing, Hungkuang University, Taichung 43303, Taiwan.
Diagnostics (Basel). 2024 Dec 6;14(23):2748. doi: 10.3390/diagnostics14232748.
This retrospective cohort study assessed dementia risk in epilepsy patients associated with the compliance to epileptic treatment visits.
We used Taiwanese insurance claims data to establish an epilepsy cohort ( = 39,216) diagnosed in 2000-2015 and a matched control cohort without epilepsy ( = 156,864), evaluating the incident dementia by the end of 2016.
The dementia incidence was 2.9-fold higher in the epilepsy cohort than in comparisons (4.68 vs. 1.59 per 1000 person-years). Only 9.3% of epilepsy patients were compliant to ≥80% of scheduled treatment visits, but they exhibited a 7.2-fold higher dementia incidence than those without treatment. The contrast was greater in younger patients than in the elderly (20-fold versus 5.5-fold). Dementia incidence increased with the frequency of neurological consultations, peaking in the first year after epilepsy diagnosis.
Epileptic patients with more clinical visits for active treatment had a higher chance of dementia diagnosis, highlighting the importance of close neurological monitoring post-epilepsy diagnosis to address potential dementia complications.
这项回顾性队列研究评估了癫痫患者中与癫痫治疗就诊依从性相关的痴呆风险。
我们使用台湾地区的保险理赔数据建立了一个在2000年至2015年期间被诊断出的癫痫队列（n = 39216）以及一个匹配的无癫痫对照队列（n = 156864），评估截至2016年底的痴呆发病率。
癫痫队列中的痴呆发病率比对照组高2.9倍（每1000人年分别为4.68例和1.59例）。只有9.3%的癫痫患者遵守了≥80%的预定治疗就诊，但他们的痴呆发病率比未接受治疗的患者高7.2倍。年轻患者与老年患者相比，这种差异更大（分别为20倍和5.5倍）。痴呆发病率随着神经科会诊频率的增加而上升，在癫痫诊断后的第一年达到峰值。
接受积极治疗的临床就诊次数更多的癫痫患者痴呆诊断的机会更高，这凸显了癫痫诊断后密切神经学监测以应对潜在痴呆并发症的重要性。
