What are the concerns of older adults with epilepsy? This was the question posed by researcher Roy Martin, Associate Professor, University of Alabama Birmingham (UAB) Department of Neurology, Laura Vogtle, Associate Professor, UAB Department of Occupational Therapy, Frank Gilliam, Professor of Neurology, Columbia University Medical Center and Edward Faught, Professor, UAB Department of Neurology in a recent study which included 33 adults age 60 and older. The goal of the study was to examine the concerns expressed by older adults with epilepsy (OAE) living with recurrent seizures. All participants in the study were being treated for intractable partial epilepsy and all were receiving antiepileptic drug therapy. Participants were each given a blank sheet of paper and asked to write down any concerns they had about living with epilepsy in order of importance.

“What we found was that 64% of the patients expressed concern regarding driving and transportation. The underlying issues of course were fears about loss of independence and increase in dependence on others. These patients feel burdensome to family and friends without the ability to drive and access to public transportation. Not being able to get in their car when they want to and having to schedule things in advance based around when they can secure transportation is a major issue and concern to them,” said Martin. Vogtle further noted, “20% of people with active seizures still drive in Alabama even when they aren’t supposed to due to lack of reliable public transportation or paratransit services in rural areas. People with intractable epilepsy, especially the older adults are truly isolated when they can no longer drive, which really affects their quality of life.”

The second biggest concern expressed by participants was medication side effects (64%) followed by personal safety (39%), AED costs (29%), employment (26%), social embarrassment (21%), and memory loss (21%).

The researchers concluded,"quality-of-life issues in OAE appear similar in content to those of younger epilepsy groups. However, medication side effects appear more concerning to older adults as compared with earlier studies with younger patients.”

“A major issue of older adults is that often times their epilepsy coincides with other health conditions such as heart disease, diabetes etc. Therefore, they are more likely to be concerned about side effects associated with AEDs as well as medication interactions. Also, the cost of medications is of concern as many older adults are on fixed incomes,” said Martin.

Both Martin and Vogtle have expanded their research with OAE to examine more closely quality-of-life issues as they pertain to transportation. In another study funded by the Centers for Disease Control and Prevention, they surveyed adults who were restricted and not restricted from driving to develop an understanding of their quality of life. They will be presenting their latest findings at the American Epilepsy Society annual conference in December, 2005.

References

Martin, R., Vogtle, L., Gilliam, F., Faught, E. “What are the concerns of older adults with epilepsy?” Epilepsy Behav, 2005; 7(2): 297-300.