Epilepsy is a neurological disorder involving seizures, episodes of abnormal electrical signaling in the brain. While epilepsy is commonly onset before age 20, it is most prevalent among those 70 and older. Public health professor Evan Thacker and his colleagues researched cognitive decline among individuals with epilepsy and a vascular risk factor.
Cognitive decline affects the brain’s functions of thinking, memory, and processing speed. Vascular risk factors increase the chance of blood vessel diseases such as hypertension, smoking, and heart disease—putting individuals at risk for faster cognitive decline and earlier onset dementia. Thacker hopes these findings will encourage further research to protect the brain health of older individuals with epilepsy.
“When we think about the health of older people in our society,” Thacker says, “one of the most important things for them is the health of their brain.”
Thacker’s findings show that epilepsy is associated with faster cognitive decline when certain vascular risk factors are present. The cognitive decline observed from the interaction between epilepsy and hypertension, for example, was almost twice the decline that occurred in people who did not suffer from either disease.
Additionally, vascular risk factors including stroke, high triglyceride levels, smoking, and coronary heart disease were all associated with a more rapid cognitive decline when combined with epilepsy.
Individuals with epilepsy are also more heavily burdened with vascular risk factors than the average person. Coupled with Thacker’s findings that vascular risk factors have a greater negative effect on the brain for people with epilepsy, monitoring for these factors may be more important than previously realized.
Modifying lifestyle can prevent some of these factors such as hypertension, coronary heart disease, and smoking. Thacker explains that proper diet and exercise promote healthy blood vessels and ultimately brain health.
When people with epilepsy are meeting with an epilepsy specialist, that doctor’s main concern is likely to be reducing seizures, Thacker says. “Our work suggests that the epilepsy doctor and patient may benefit from paying attention to the risk of having other bad things happen in their brain, like having a stroke or getting dementia, both of which are tied to the health of the blood vessels.”
Thacker was surprised that his team did not find additional associations between epilepsy and certain vascular risk factors, but he attributes that to the study's relatively small sample size. Their recent study included approximately 200 people with epilepsy compared to 5,000 people without epilepsy. In order to advance this line of research linking epilepsy with vascular health, Thacker and his colleagues have recently acquired funding from the National Institutes of Health for a much larger study, to be conducted over five years. This study is expected to involve about 1,600 people with epilepsy compared with 40,000 without.
Thacker hopes that this newly funded research will advance our knowledge and is eager for the help new data may provide to aging epilepsy patients.
“If we find stronger evidence that epilepsy plus vascular risk factors increase your risk of cognitive decline, dementia, and stroke,” Thacker says, “that could lead to recommendations for doctors to pay more attention to the overall health of the brain of epilepsy patients in addition to seizure prevention.”
Find Thacker's study here.