If someone you love lives with epilepsy, this new study deserves a calm, careful read. A big analysis of national health records found that people with epilepsy are more likely to develop dementia before age 65. The epilepsy dementia risk is real in the data, but the researchers say the absolute risk stays low.
The findings were published October 14 in Neurology, the journal of the American Academy of Neurology. The team used national databases in France and Sweden.
What the epilepsy and dementia link looks like in the data
Doctors call dementia that starts before 65 young-onset dementia. Earlier research tied epilepsy to dementia late in life, but evidence on the younger form was thin, according to study author Vincent Navarro, MD, PhD, of Sorbonne University in Paris. So the team went looking.
They used two designs. The first looked backward. Each person with young-onset dementia was matched to 10 people of the same age and sex without it. Researchers then checked for epilepsy or epilepsy drug use in the 10 years before.
The numbers are big. France supplied 11,360 people with young-onset dementia and 113,600 without. Sweden supplied 16,433 and 164,330. Medical Xpress reports that 27.3% of those with dementia had received epilepsy medications, versus 10.3% of those without.
The second design went forward. It followed 12,901 people newly diagnosed with epilepsy, 64,083 with existing epilepsy and 129,010 without the condition. That adds up to roughly 206,000 people, which likely explains the 200K figure in the headlines.
A local report on the study says French rates of dementia before 65 were 11% higher in people with epilepsy.
Why young-onset dementia risk matters, and why it shouldn’t panic you
Here’s the thing: this is an association, not proof of cause. The study does not show that epilepsy causes dementia. And the American Academy of Neurology says the absolute risk remains low.
So what can people do with this? Navarro’s answer is practical. “These results support integrating dementia prevention into the care of people with epilepsy,” he said. He added that they may benefit from earlier checks of their thinking skills, and from tighter control of risks they can change, such as high blood pressure.
That’s a useful message for families, too. If someone you love lives with epilepsy, the study is a reason to ask their doctor about cognitive screening. It is not a reason to expect the worst.
Other research points the same way: a recent Mediterranean diet study also found a link, not a cure, and lifestyle factors like exercise matter as well, as work on Parkinson’s and activity shows. For more on the science of cognitive decline, see our report on rapamycin and brain blood flow.
Several details are still missing. The Neurology paper’s hazard ratios, confidence intervals and country-by-country follow-up results were not available at the time of writing. Those numbers will show just how big the added risk really is.
Until then, early dementia in epilepsy is worth watching. The question for families is a simple one: at the next appointment, will someone ask about brain health?
