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.

Method 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.

CSF: Cerebro Spinal Fluid

CT: Computerized Tomography

ECG: Electrocardiography

EEG: Electroencphalogram

ILAE: International League Against Epilepsy

MRI: Magnetic Resonance Imaging

mRS: Modified Rankin Scale

OPD: Out Patient Department

QOL: Quality of life

SD: Standard Deviation

N.M. contributed to the design and conceptualization of the study, data collection and analysis, and drafting of the manuscript. N.C. contributed to acquisition of data and revision of the manuscript for intellectual content. P.S.K., S.V., A.A., and P.P. contributed to the design of the study and revision of the manuscript for intellectual content. J.B. contributed to the design and conceptualization of the study, data collection and analysis, and drafting and revision of the manuscript for intellectual content.

This manuscript is neither published in part nor full. The abstract was presented at the 14th European Epilepsy Congress, Geneva, 2022.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Article published online:
01 October 2024

© 2024. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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