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Tackling increased risks in older adults with intellectual disability and epilepsy: Data from a national multicentre cohort study.
Watkins, L V; Henley, W; Sun, J J; Perera, B; Angus-Leppan, H; Sawhney, I; Purandare, K; Eyeoyibo, M; Scheepers, M; Lines, G; Winterhalder, R; Shankar, R.
Afiliación
  • Watkins LV; University of South Wales, Pontypridd, UK; Swansea Bay University Health Board, Port Talbot, UK.
  • Henley W; University of Exeter Medical School, Exeter, UK.
  • Sun JJ; Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK; Royal Free London NHS Foundation Trust, London, UK.
  • Perera B; Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK.
  • Angus-Leppan H; Royal Free London NHS Foundation Trust, London, UK; Institute of Neurology, University College London.
  • Sawhney I; Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK.
  • Purandare K; Central and Northwest London NHS Foundation Trust, London, UK.
  • Eyeoyibo M; Kent and Medway NHS and Social Care Partnership Trust, Kent, UK.
  • Scheepers M; Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK.
  • Lines G; Oxleas NHS Foundation Trust, London, UK.
  • Winterhalder R; Oxleas NHS Foundation Trust, London, UK.
  • Shankar R; Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, UK; Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, Truro, UK. Electronic address: Rohit.shankar@plymouth.ac.uk.
Seizure ; 101: 15-21, 2022 Oct.
Article en En | MEDLINE | ID: mdl-35850018
PURPOSE: People with intellectual disabilities (ID) suffer multimorbidity, polypharmacy and excess mortality at a younger age than general population. Those with ID and epilepsy are at higher risk of worse clinical outcomes than their peers without epilepsy. In the ID population the health profile of those aged ≥40 years can be compared to those aged over 65 in the general population. To date there is limited data available to identify clinical characteristics and risk factors in older adults (≥40 years) with ID and epilepsy. METHODS: The Epilepsy in ID National Audit (Epi-IDNA) identified 904 patients with ID and epilepsy from 10 sites in England and Wales. This subsequent analysis of the Epi-IDNA cohort compared the 405 adults over 40 years with 499 adults ≥18 years aged under 40 years. Comparison was made between clinical characteristics and established risk factors using the Sudden Unexpected Death in Epilepsy (SUDEP) and Seizure Safety Checklist. RESULTS: The older adults' cohort had significantly higher levels of co-morbid physical health conditions, mental health conditions, anti-seizure medications (median 5), and antipsychotics compared to the younger cohort. The older group were significantly less likely to be diagnosed with a co-morbid neurodevelopmental disorder, and to have an epilepsy care plan. CONCLUSION: This is the largest study to date focused on adults with ID and epilepsy over 40 years. The ≥40 years cohort compared to the younger group has higher levels of clinical risk factors associated with multi-morbidity, potential iatrogenic harm and premature mortality with worse clinical oversight mechanisms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epilepsia / Discapacidad Intelectual Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Seizure Asunto de la revista: NEUROLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epilepsia / Discapacidad Intelectual Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Seizure Asunto de la revista: NEUROLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido