IEC 2025 | The prevalence of psychiatric comorbidities in older adults with epilepsy

There’s been very little research on this subject, but we know from the general population and from some of the epidemiological studies that are there that depression and anxiety are very common in people with epilepsy, including those who are older. And we know very little about non-epileptic attack disorder or dissociative seizures in people who also have epilepsy or who have just those. And that’s one of the big areas where we’re really lacking knowledge. But for anxiety and depression, these are important comorbidities. We do know that they are common and that the average sort of estimates are between 20 or more percent of people with epilepsy who are older. And by older, I’m defining that as being more than 60, although there’s not even a consensus about what older really means. Important areas that need to be addressed because they interact with quality of life enormously, of course with the medication choices, and also with the fact that it may affect adherence to the medications as well. Areas which need a lot more research. We also don’t know how much variation there is from country to country and how the presentations of, say, depression or anxiety may differ in older people. And this is a really important point because in older people, there may be more biological emphasis in their symptomatology. They may not present with saying, “I feel really low in mood.” It may manifest as being loss of weight, early wakening, poor appetite, loss of interest in activities for depression. And so it’s really important to be aware of them.

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