Abstract
Objective The incidence of seizures is highest in the elderly, and their management is challenging
in view of atypical presentation and comorbidities. The aims of this analysis were
to study the classification, etiology, and risk factors in new onset seizures in the
elderly (>60 years) and their impact on the quality of life (QOL) and caregiver burden.
Materials and Methods All the elderly presenting to neurology, neurosurgery and emergency medicine OPD
with new onset seizures after the age of 60 years were included. QOL and caregiver
burden were assessed at least 6 months after the first seizure. The QOL was assessed
with the World Health Organization Quality of Life OLD (WHOQOL-OLD) and was compared
with age-matched controls. Caregiver burden was assessed with the Zarit Burden Interview.
Result Eighty patients fulfilling the inclusion criteria and 80 age-matched controls were
recruited. There was no difference in age (68.30 ± 6.22 vs. 69.09 ± 6.07 years; p = 0.39) and gender (M:F = 50:30 vs. 48:32; p = 0.74) among the cases and controls. Forty-four (55%) patients had focal seizure.
Hypertension was the commonest risk factor (61.3%), followed by ethanol intake (40%)
and diabetes (38.8%). Cerebrovascular disease was the commonest etiology (37.5%),
followed by infection (15%). Thirteen (16.2%) patients died during hospital stay and
20 (25%) died after discharge from the hospital. Cases scored significantly low on
all domains of WHOQOL-OLD at 6 months of follow-up. In all, 54.1% caregivers reported
mild to moderate burden.
Conclusion Focal seizure is the commonest seizure type of new onset seizure in the elderly.
Hypertension is the commonest risk factor and cerebrovascular disease is the commonest
etiology. New onset seizures in the elderly have a significant impact on both QOL
and caregiver burden.
Keywords
late onset seizures - new onset seizures in the elderly - quality of life - caregiver
burden
