Incidence of new-onset seizures in mild to moderate Alzheimer disease

To estimate the incidence rate and predictors of seizures in patients with mild to moderate Alzheimer disease (AD). Cohort study of patients with mild to moderate AD in clinical trials. Risk factors for potential seizures were evaluated by stratified descriptive statistics and univariable and multiv...

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Veröffentlicht in:Archives of neurology (Chicago) Jg. 69; H. 3; S. 368
Hauptverfasser: Irizarry, Michael C, Jin, Shelia, He, Feng, Emond, Jennifer A, Raman, Rema, Thomas, Ronald G, Sano, Mary, Quinn, Joseph F, Tariot, Pierre N, Galasko, Douglas R, Ishihara, Lianna S, Weil, John G, Aisen, Paul S
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.03.2012
Schlagworte:
Age of Onset
Aged
Alzheimer Disease - complications
Alzheimer Disease - epidemiology
Apolipoproteins E - genetics
Cognition Disorders - epidemiology
Cognition Disorders - psychology
Confidence Intervals
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neuropsychological Tests
Proportional Hazards Models
Risk Factors
Seizures - complications
Seizures - drug therapy
Seizures - epidemiology
Treatment Outcome
ISSN:1538-3687, 1538-3687
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Zusammenfassung:To estimate the incidence rate and predictors of seizures in patients with mild to moderate Alzheimer disease (AD). Cohort study of patients with mild to moderate AD in clinical trials. Risk factors for potential seizures were evaluated by stratified descriptive statistics and univariable and multivariable Cox proportional hazards regressions. Pooled patient-level data from 10 Alzheimer Disease Cooperative Study clinical trials in mild to moderate AD from 1995 to 2010. Three thousand seventy-eight subjects randomized to the treatment or placebo arms of 10 AD clinical trials. Screening Mini-Mental State Examination scores ranged between 10 and 28. Eighteen seizures were reported in 3078 randomized subjects, with an incidence rate of 484 per 100 000 person-years (95% CI, 287-764). Statistically significant independent risk factors for seizure were younger age (adjusted hazard ratio, 0.80; 95% CI, 0.69-0.93 per every 5 years of age), greater cognitive impairment at baseline (adjusted hazard ratio, 2.79; 95% CI, 1.06-7.33 for Mini-Mental State Examination scores <18 compared with Mini-Mental State Examination scores ≥18), and antipsychotic use at baseline (adjusted hazard ratio, 3.47; 95% CI, 1.33-9.08). Seizure rates in patients with mild to moderate AD in clinical trials are similar to rates observed in longer observational cohort studies, but they are greater than expected in the general elderly population. Younger age, greater degree of cognitive impairment, and history of antipsychotic use were independent risk factors for new-onset seizures in AD.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1538-3687
1538-3687
DOI:10.1001/archneurol.2011.830