Poststroke seizures, epilepsy tied to increased dementia risk

Stroke survivors with seizures or epilepsy are at greater risk of dementia, according to a retrospective study.

For the study, researchers used data from the Taiwan National Health Insurance Research Database. They looked at 62,968 acute stroke patients (average age 63 years, 62.9 percent male), excluding those with pre-existing neurological conditions. Patients with poststroke seizures or poststroke epilepsy were matched to those without based on age, sex, stroke severity level, and the year of index stroke.

Of the patients, 60.3 percent had ischaemic strokes while 39.7 percent had haemorrhagic strokes. Over an average follow-up period of 5.2 years, the main outcome of incident dementia was documented in 15.9 percent of patients who had poststroke seizure or poststroke epilepsy as opposed to 8.4 percent of those without these poststroke conditions.

In a time-dependent Fine and Gray competing risk analysis, both poststroke seizure and poststroke epilepsy had a significant association with dementia across all stroke types. Further analyses showed significantly increased risk of dementia across subgroups defined by age (<50, 50–64, and ≥65 years), sex, and various stroke severity levels.

The association of poststroke seizure and poststroke epilepsy with incident dementia was especially pronounced in men, with a less distinct correlation in women.

The findings underscore the potential of screening and therapeutic interventions for seizures and epilepsy in terms of reducing dementia among stroke survivors.