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The impact of epilepsy on older veterans.

Pugh MJ, Berlowitz DR, Kazis L. The impact of epilepsy on older veterans. International Review of Neurobiology. 2007 Jan 1; 81:221-33.

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Despite the fact that old age is the time with the highest incidence of epilepsy, little is known specifically about the impact of epilepsy on the daily lives of the elderly. Previous studies have explored the impact of epilepsy on health status in a general population, but typically have not included enough older individuals to adequately describe this population. The study on which this chapter is based used a general survey instrument to begin exploration of this issue in a population of older veterans with epilepsy. Older patients ( > or = 65 years of age) were identified who had both International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes indicating epilepsy and prescriptions of antiepileptic drugs in national Veterans Affairs (VA) administrative and pharmacy databases during fiscal year 1999. Using these databases, patients were further identified as newly or previously diagnosed. Diagnostic data were then linked with data from the 1999 Large Health Survey of Veteran Enrollees, using encrypted identifiers, and the impact of epilepsy on patients of different ages was assessed using individual scales and component summaries of the Veterans SF-36. Results showed that older individuals with epilepsy had lower scores on measures of both physical and mental health than did their counterparts with no epilepsy. Further, scores associated with mental health functioning were significantly lower for those with newly diagnosed epilepsy than for those with chronic epilepsy, but differences associated with scores on physical functioning were not significant. Thus, while previous studies suggest that the effects of chronic neurological disorders such as epilepsy are most obvious on measures of mental health, these data suggest that older patients experience difficulties in both physical and mental health.

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