Analysis of the Correlation between Frailty Index, Clinical Characteristics, Use of Anti-Epileptic Drug, and Prognosis in Elderly Patients with Epilepsy

TL;DR

This study explores how frailty, age, health conditions, and medication use affect the prognosis of elderly epilepsy patients.

Contribution

The study identifies key clinical and demographic factors linked to seizure severity in elderly epilepsy patients.

Findings

Older age, longer disease duration, and comorbidities like diabetes and heart disease correlate with more severe seizures.

Frailty is strongly associated with increased major seizures, with non-frail patients experiencing fewer severe episodes.

Regular medication use and polypharmacy are linked to better seizure control in elderly epilepsy patients.

Abstract

Epilepsy is a common neurological disorder among the elderly, often leading to significant morbidity. Therefore, it is necessary to study the correlation between the frailty index, clinical characteristics of epilepsy, use of anti-epileptic drug, and the prognosis of elderly patients with epilepsy.

This retrospective study included 106 elderly patients with epilepsy who were treated at the Affiliated Mindong Hospital, Fujian Medical University, China, between January 2018 and December 2022. Based on the severity of the prognosis, the seizures were classified into the major seizure group (tonic-clonic), minor seizure group (absence, myoclonus, clonus, tonic, atonic and partial seizures), and no seizure group. Furthermore, the relationship between the frailty index, clinical characteristics, use of epilepsy drugs, and the degree of epileptic seizures was assessed using the Logistic regression analysis.

Univariate analysis indicated that older age (p < 0.001), longer disease duration (p = 0.009), and the presence of comorbid conditions such as diabetes (p = 0.002) and coronary heart disease (p < 0.001) were all associated with seizure severity. Additionally, frailty was significantly related to seizure severity, with the non-frailty group having fewer major seizures compared to the pre-frailty and frailty groups (p < 0.001). Similarly, regular medication use (p < 0.001) and the number of drugs taken (p < 0.001) were significant factors, with irregular medication use and single-drug regimens being more common in patients with more severe seizures. Multivariate Logistic regression analysis indicated that a higher frailty index (p = 0.033), age over 70 years (p = 0.015), longer disease duration (p = 0.003), the presence of coronary heart disease (p < 0.001), and regular medication use (p = 0.022) were all significantly associated with more severe seizures.

Frailty index, age, disease duration, coronary heart disease, and regular medication are related to the prognosis of elderly patients with epilepsy. These findings highlight the significance of comprehensive management strategies to improve clinical outcomes in this group of patients.