Ying Xu1,2, Louise Lavrencic1,3, Kylie Radford1,3, Andrew Booth4, Sohei Yoshimura5, Kaarin J Anstey1,2, Craig S Anderson3,6,7,8, Ruth Peters1,2,9. 1. Neuroscience Research Australia, Sydney, New South Wales, Australia. 2. School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia. 3. Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. 4. School of Health and Related Research, University of Sheffield, Sheffield, UK. 5. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. 6. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. 7. The George Institute for Global Health, Peking University Health Science Centre, Beijing, China. 8. Neurology Department, Sydney Local Area Health District, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. 9. School of Public Health, Imperial College London, London, UK.
Abstract
BACKGROUND/ OBJECTIVES: Coexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics. DESIGN: A systematic review and meta-analysis (PROSPERO protocol registration CRD42020150479). SETTING: Population-, community-, hospital-, or nursing home-based. PARTICIPANTS AND MEASUREMENTS: Thirty-nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I2 ) were not shown, rates were synthesized using random effect. RESULTS: Studies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person-years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early-onset AD) in one study. Meta-analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14-19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult-onset seizures had AD (95%CI, 7-14). CONCLUSION: Seizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.
BACKGROUND/ OBJECTIVES: Coexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics. DESIGN: A systematic review and meta-analysis (PROSPERO protocol registration CRD42020150479). SETTING: Population-, community-, hospital-, or nursing home-based. PARTICIPANTS AND MEASUREMENTS: Thirty-nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I2 ) were not shown, rates were synthesized using random effect. RESULTS: Studies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person-years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early-onset AD) in one study. Meta-analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14-19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult-onset seizures had AD (95%CI, 7-14). CONCLUSION:Seizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.
Authors: Juan Fortea; Shahid H Zaman; Sigan Hartley; Michael S Rafii; Elizabeth Head; Maria Carmona-Iragui Journal: Lancet Neurol Date: 2021-11 Impact factor: 59.935