Black nursing home patients have an incidence rate of epilepsy almost twice that of white patients, while patients from other ethnicities have an incidence nearly 1.5 times higher.
SAN ANTONIO—The incidence of epilepsy and seizure disorder among nursing home residents varies widely across racial and ethnic groups, and with certain predisposing conditions, according to the results of a study presented at the 64th Annual Meeting of the American Epilepsy Society.
“A significant number of elderly [nursing home] residents have new-onset [epilepsy or seizure disorder] during their [nursing home] stay,” reported Ilo E. Leppik, MD, Adjunct Professor of Neurology at the University of Minnesota, Minneapolis, and colleagues. The finding raises questions about how to best treat the disorder in a diverse population.
The researchers examined Minimum Data Set assessments for nursing home patients 65 and older. Subjects’ race/ethnicity and any conditions that the investigators identified as precursors for epilepsy were recorded, including stroke, hemiplegia, head injury, brain tumor, dementia, multiple sclerosis (MS), Parkinson’s disease, diabetes mellitus, hypertension, and primary and secondary nonbrain cancers.
There were 2,775,299 residents without prevalent epilepsy or seizure disorder included in the study—2,423,006 (87.3%) were white, 226,768 (8.2%) were black, and 125,525 (4.5%) were of other ethnicities (American Indian/Alaskan Native, Asian/Pacific Islander, and Hispanic). The investigators then computed the number of epilepsy or seizure events per 10,000 person-years.
Overall, Dr. Leppik’s group found that epilepsy incidence among black nursing home residents was 305.9 events per 10,000 person-years, compared with 157.6 among white residents. The rate among all other combined racial/ethnic groups was 235.8, almost 1.5 times higher than white residents.
“Incidence varies widely by baseline conditions that are potential precursors to seizures,” the researchers stated. The greatest predictors for epilepsy incidence rates were baseline brain tumor, hemiplegia, head injury, and stroke. Lower rates were seen in residents with primary and secondary nonbrain cancers, diabetes mellitus, Parkinson’s disease, hypertension, dementia, and MS. In all conditions except Alzheimer’s disease, black patients had a higher incidence rate than all other ethnicities. The researchers noted that these differences persisted even among healthier patients who had no identified precursors for epilepsy.
The investigators had initially suggested that incidence of epilepsy and seizure disorder in nursing home residents was likely to differ by racial/ethnic groups, because the prevalence of these precursors differs by racial/ethnic groups in the overall population.
“With the racial/ethnic makeup of US nursing home residents changing with the US population,” they concluded, “it is important for [nursing home] caregivers and administration to understand racial/ethnic differences in such precursors and subsequent seizures due to the potentially severe consequences that seizures hold for elderly residents.”
—Ariel Jones