Abstract
Objective: The point prevalence of epilepsy is high in nursing homes (NH), but the incidence of epilepsy after admission is unknown. This study was done to determine the incidence of epilepsy/seizure (epi/sz) comorbid with other conditions in older adult NH residents. Design: Retrospective evaluation of Minimum Data Set records to identify new onset epi/sz in NH residents. Setting and Participants: Five cross-sectional cohorts of all residents in any Medicare/Medicaid certified NH in the United States on July 15 of each year 2003-2007. Measures: Epi/sz was identified by International Classification of Diseases, Ninth Revision codes (345.xx or 780.39) or check box on the Minimum Data Set. Those with no such code on admission and with 1 to 3 plus years of follow-up (n = 3,609,422) were followed through 2007 or end of stay. Results: Overall incidence of epi/sz was 16.42/1000 patient years (PY). Incidence was highest in the first year after admission and declined thereafter. There were more women (n = 2,523,951) than men (n = 1,089,631), but men had a higher incidence (21.17/1000PY) compared with women (14.81/1000PY). Although the 65‒74 years of age cohort included fewer residents (n = 594,722) compared with the age 85 years + cohort (n = 1,520,167), the younger residents had the highest incidence (28.53/1000 PY) compared with the oldest, 10.22/1000 PY for the age 85+ years cohort. The highest incidences were among those with brain tumor (122.55/1000PY), followed by head injury (45.66/1000PY). Overall, 714,340 had a diagnosis of stroke, and incidence was 27.52/1000PY. Those with none of selected risk factors had an overall incidence of 12.45/1000PY. Conclusions and Implications: The incidence of epi/sz in older individuals after admission to a NH is high. There is a need to develop practice approaches to best manage this large cohort. There does not appear to be a uniform approach to managing new onset epilepsy in NHs at this time. Studies to develop evidence for practice guidelines are needed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1589.e11-1589.e15 |
| Journal | Journal of the American Medical Directors Association |
| Volume | 23 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2022 |
Bibliographical note
Funding Information:This project was supported by grant number ASPH / CDC #S-382 (LEE, IEL, KS) and the National Institutes of Health 5R01AG026390 (AKB, LEE, IEL) from the National Institute on Aging (NIA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control, the NIA, or the National Institutes of Health.
Funding Information:
Research efforts by Drs. Birnbaum, Eberly, and Leppik were funded in part by NIH / NIA 5R01AG026390 ; Dr. Eberly, Dr. Leppik, and Mr. Svensden were also funded in part by ASPH / CDC #S-3822 . Dr. Leppik has received honoraria for consulting from Sunovion and for speaking from Eisai.
Funding Information:
This project was supported by grant number ASPH/CDC #S-382 (LEE, IEL, KS) and the National Institutes of Health 5R01AG026390 (AKB, LEE, IEL) from the National Institute on Aging (NIA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control, the NIA, or the National Institutes of Health.Research efforts by Drs. Birnbaum, Eberly, and Leppik were funded in part by NIH/NIA 5R01AG026390; Dr. Eberly, Dr. Leppik, and Mr. Svensden were also funded in part by ASPH/CDC #S-3822. Dr. Leppik has received honoraria for consulting from Sunovion and for speaking from Eisai.
Publisher Copyright:
© 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Keywords
- Incidence
- brain trauma
- dementia
- epilepsy/seizures
- stroke
