The question of whether a person has epilepsy or Alzheimer’s can be a tough one.
Take those “senior moments” — memory lapses, zoning out and other temporary confusion. These seemingly harmless incidents may actually be a sign of epilepsy. Roughly 1-2 percent of seniors develop epilepsy — and that rate is rising.
But experts at the U.S. National Council on Aging warn that often epilepsy goes undetected in seniors.
Yet epilepsy affects some 300,000 seniors in the United States, and older adults are the fastest growing population group with epilepsy. By 75 years of age, three percent of the population will likely be diagnosed with epilepsy, 10 percent will have had a seizure of some type. In contrast, only 1 percent will have developed epilepsy by age 20.
“Epilepsy is one of the most often misdiagnosed, mistreated, or under treated conditions affecting seniors,” said James Firman, president and CEO of the council. We believe seniors, their families, and their caregivers need to be more aware of the growing prevalence of epilepsy in this age group so they can discuss telltale symptoms with their physicians.”
Alzheimer’s and epilepsy…
When people have unprovoked seizures, or seizures with no known causes, doctors diagnose epilepsy.
According to the Epilepsy Foundation, about 300,000 seniors currently suffer from epilepsy, and the number of seniors with the condition continues to grow.
Doctor’s believe that Alzheimer’s disease results from plaques in a person’s brain, although they aren’t sure what causes those plaques to develop. A number of Alzheimer’s patients also experience seizures, which may result from those same plaques.
Stroke is the most common cause of seizures in older adults, causing about 33 percent of all cases of senior epilepsy.
And seniors with pre-existing cardiovascular disease, have an increased risk for developing epilepsy.
Seniors are also at risk for dementia, including Alzheimer’s disease, which is the second most common cause of epilepsy in older adults. These degenerative diseases damage the brain and, very often, result in seizures.
And it’s also possible that epilepsy in a senior citizen marks the return of a seizure disorder that was in remission, or it may be the continuation of a life-long problem.
Seizures versus epilepsy…
While epilepsy, Alzheimer’s disease, stroke, and heart attacks remain the most common causes of seizures in the elderly, other things can cause seizures in senior citizens. Like endocrine disorders, fever, electrolyte imbalances, infections of the central nervous system (like meningitis), and brain tumors.
Arteries may become narrowed or clogged, depriving parts of the brain of blood and oxygen. The resulting damage may produce seizures.
Bleeding in the brain, which is another form of stroke, may also leave a person with seizures afterwards.
Heart attacks may temporarily cut off oxygen to the brain, causing seizures.
Complications of diseases, like liver and kidney disease, alcoholism and even diabetes may make people more likely to have seizures in later life.
Brain tumors of any kind may cause seizures. And brain diseases that change the internal structure of the brain, may cause seizures.
Scar tissue from an operation on the brain, may cause seizures later on.
Also a number of common medications can cause seizures in some patients, including antipsychotics, antidepressants, insulin, and some painkillers. Withdrawal from certain medications, such as sedatives, can also cause seizures.
Solutions?
For some unknown reason, elderly onset epilepsy is usually easier to control compared to epilepsy that begins in a younger age.
Also, some of the second-generation AEDs seem to be more easily tolerated by the elderly versus the first-generation AEDs.
So you have to ask: “If elderly patients with epilepsy tolerate some of the newer AEDs better, why do physicians continue to prescribe first-generation AEDs?”
One argument that some physicians use is that older anti-epileptic drugs are cheaper. But the patients pay a price. And recent studies suggest the use of first-generation AEDs may actually be more expensive in terms of total health care costs.
To add insult to injury, first-generation medications have strong interactions with many other medications that seniors take, which doesn’t happen with some of the new generation AEDs. One of the major and most used drugs that has poor interactions with first-generation AEDs is statins. And how many people do you know who take statins? (I’m 67 and I take statins!)
So you can see, there’s still a lot of work to be done in the research field. Whether it’s Alzheimer’s, epilepsy or seizures…the first step is to recognize them. And then the next step is to develop the proper protocols and medications to treat them.
For a fascinating read, click here: Epilepsy drugs as ‘chemical restraint’ on rise in nursing homes https://www.washingtonpost.com/business/2022/11/17/nursing-home-drugs-dementia/?pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWJpZCI6IjEyMjgxMzg5IiwicmVhc29uIjoiZ2lmdCIsIm5iZiI6MTY2ODc3MjYwMCwiaXNzIjoic3Vic2NyaXB0aW9ucyIsImV4cCI6MTY2OTk4MjIwMCwiaWF0IjoxNjY4NzcyNjAwLCJqdGkiOiIyYjdkMzYxYi1hMmUzLTQwZWEtOGQ1ZC03NmY0YWIxNGYzYjMiLCJ1cmwiOiJodHRwczovL3d3dy53YXNoaW5ndG9ucG9zdC5jb20vYnVzaW5lc3MvMjAyMi8xMS8xNy9udXJzaW5nLWhvbWUtZHJ1Z3MtZGVtZW50aWEvIn0.digP29MLFadEYVJlxzLqinoLs0r_40N7A-zuBVCh2qA
Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482722/
https://www.webmd.com/alzheimers/news/20170502/silent-seizures-tied-to-alzheimers-symptoms#1
http://www.ehow.com/facts_5882806_causes-seizures-elderly_.html
http://www.everydayhealth.com/epilepsy/understanding/epilepsys-and-older-people.aspx
https://academic.oup.com/brain/article/141/6/1592/4915830
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Absolutely fascinating.
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Comment by laura and michael hood hood allan — March 14, 2020 @ 4:56 AM
Thank you. I’m glad you were able to get something out of it!
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Comment by Phylis Feiner Johnson — March 14, 2020 @ 10:02 AM
It occurred to me as I was reading this, that would the outcomes be different for those of us who have a VNS or other devices? My neurologist tells me (I asked) if my VNS would work better the longer it was implanted, and she said it would. So, if we’re the first generation to age with the benefit of technology as well as chemistry, what do you think, could this be a gamechanger?
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Comment by catsissie — March 15, 2020 @ 1:03 PM
That’s a fabulous point and I, too, see it as a point for optimism.
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Comment by Phylis Feiner Johnson — March 15, 2020 @ 4:48 PM
Many decades ago my grandparents ALWAYS cooked & baked foods with ALUMINUM cookware & years later they started for forget many things & it was never a diagnosis to that, just called OLD AGE. The a few decades later all ALUMINUM cookware was a NO NO to use, & STAINLESS STEEL utensils were than answer while the ALUMINUM METALS were starting to be found in more FOODS, and young teens, kids & infants started having some BAD DISEASES for no apparent reason or cause to blame. Now for the past 45 years we have had the MICROWAVE & food prepared in 5 minutes oir less. Great ! YUM YUM as you do not have to look hard to see the RISE & INCREASES in all brain conditions that have been diagnosed over the past 50 years since 1970. That does not include all vaccines, flu shots & the drugs since then, with ALUMINUM & MERCURY that have it in them since the 1960’s after ALUMINUM COOKWARE was stopped being made. call me crazy if you like, as I say NO to any of that & have been since the early 1970’s after knowing all what SACCHARIN had done to my brain chemistry with having MORE seizures, and as I have never had any ASPARTAME from my hand to mouth unless it was in a drug that I knew nothing about, I know my brain has never had the seizures it use to have, Plus I am preventing any of it from getting any other brain condition from MS,Alzhiemers & others as Epilepsy is bad enough for over 59 years. Check out what is in the drugs you are taking as ANY METAL is bad for all brain chemistry, http://www.dailymed.nlm.nih.gov The long term side effects from being on AED’s for over 59 years, I may get all the other brain conditions in the next 10 years anyway, as time will tell.
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Comment by James D — March 15, 2020 @ 7:35 PM
I agree with you James, but I don’t see how we can eliminate ALL of these things from our lives.
Yes, I replaced my mercury fillings. No, I don’t eat aspartame. Our cookware is enamel coated.
But I know there’s aluminum in my life, my meds, and the very air I breathe.
It’s a toxic world out there. But there are some things we just can’t avoid.
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Comment by Phylis Feiner Johnson — March 16, 2020 @ 12:05 AM