Worse Depressive Symptoms in Older Adults with Epilepsy
Older adults with prevalent epilepsy are at a higher risk of developing depressive symptoms over time compared with those without epilepsy, highlighting the need for ongoing depression screening in this population.
Older adults with epilepsy have worse depressive symptoms over time relative to those without epilepsy. These findings were recently published in Epilepsia.
Researchers used data from the Cardiovascular Health Study to evaluate the depressive symptom trajectory among older adults with and without epilepsy. Using a linear mixed model, the researchers estimated depression over time by epilepsy status.
Participants (N=5454) underwent an in-person evaluation at baseline, followed by up to 9 additional evaluations. At each evaluation, depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CESD-10). Of the participants, 42% were men, the mean (SD) enrollment age was 73 (5.5) years, and 190 had prevalent epilepsy. Those with prevalent epilepsy (n=190) had more comorbidities, such as diabetes, coronary heart disease, and history of stroke, than those without (n=5264).
After adjusting for demographics, smoking and alcohol use, baseline comorbidities, and life satisfaction, mean CESD-10 score increased at a significantly faster rate for patients with prevalent epilepsy than for those without. Patients with prevalent epilepsy had a CESD-10 score increase of 2.8 (95% CI, 2.1-3.6) points over 9 years. In comparison, those without epilepsy had a mean CESD-10 score increase of 1.8 (95% CI, 1.6-1.9; P =.005). The prevalent epilepsy cohort also experienced a larger increase in cases of major depression relative to the group without epilepsy, with 9.6 cases more per 100 (95% CI, 2.7-16.5; P =.007). Sex did not have a significant effect on these results.
“Our finding that older adults with prevalent epilepsy experience worse depressive symptom trajectories over time compared to older adults without epilepsy directly confirms the need for even more increased vigilance for depression.”
Study limitations include self-reported assessments and a small sample size.
“Our finding that older adults with prevalent epilepsy experience worse depressive symptom trajectories over time compared to older adults without epilepsy directly confirms the need for even more increased vigilance for depression,” the study authors concluded.
Disclosure: Some study authors declared affiliations with the National Institutes of Health (NIH). Please see the original reference for a full list of author disclosures.
References: Choi H, Stepan B, Clifton R, et al. Association of epilepsy with trajectory of depressive symptoms in late life: The Cardiovascular Health Study. Epilepsia. Published online August 1, 2025. doi:10.1111/epi.18579
Source: https://www.neurologyadvisor.com/news/epilepsy-worse-depression-symptoms-over-time/