Risk of seizures and subclinical epileptiform activity in patients with dementia: A systematic review and meta-analysis

Ageing Res Rev. 2021 Dec:72:101478. doi: 10.1016/j.arr.2021.101478. Epub 2021 Oct 1.

Abstract

Background: Seizures and subclinical epileptiform activity are common yet easily overlooked among demented patients. We aimed to investigate their epidemiological characteristics in patients with dementia from various aspects.

Methods: We retrieved relevant observational studies from PubMed and Embase Library until March 2021. Pooled estimate effects were calculated using random-effects models. This study is registered with PROSPERO, number CRD42020200949.

Results: Of the 19144 identified studies, 27 were eligible for inclusion. The pooled period prevalence rates of seizures were 4.86% (95%CI: 3.43-6.51%), 2.68% (95%CI: 2.13-3.28%), 2.81% (95%CI: 2.02-3.71%)and 7.13% (95%CI: 2.67-13.14%) among patients with Alzheimer's disease (AD), Dementia of Lewy Body (DLB), Frontotemporal dementia (FTD) and Vascular dementia (VaD), respectively. The pooled incidence rate of seizures was [8.4 (95%CI: 4.2-12.7) per 1000 person-years] in AD patients. And the pooled relative risk of seizures in patients with AD was 3.35 (95%CI: 2.69-4.19). Besides, the pooled cumulative incidence rate and prevalence rate of subclinical epileptiform activity among AD patients were [21.41% (95%CI: 0.001-63.60%)] and 9.73% (95%CI: 0.26-28.38%), respectively.

Conclusions: The accurate rates of seizures and subclinical epileptiform activities in the four major dementia types are high. Besides, patients with AD are likely at a higher risk of seizures.

Keywords: Alzheimer’s disease; Dementia; Epidemiology; Meta-analysis; Seizures.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Alzheimer Disease* / epidemiology
  • Dementia, Vascular*
  • Frontotemporal Dementia*
  • Humans
  • Lewy Body Disease*
  • Seizures / epidemiology