Incidence of epilepsy and associated factors in elderly patients in Germany

Abstract Aims Little is known about the recent epidemiology of epilepsy in the elderly in Germany. Therefore, the goal of this study was to analyze the incidence of epilepsy and associated factors in elderly patients followed in general practices in this country. Methods The incidence of epilepsy was estimated using data from all patients aged ≥ 60 years who were followed in 1203 general practices in Germany in 2017 (IQVIA Disease Analyzer database). The association between predefined variables and epilepsy was further studied using a case–control design (n = 4690 matched pairs). Cases were patients aged ≥ 60 years who had received a first diagnosis of epilepsy in general practices between 2015 and 2017 (index date). Controls without epilepsy were matched (1:1) to cases by age, gender, index year, and physician. Results The incidence of epilepsy was 157 per 100,000 elderly persons. This incidence increased with age (92 per 100,000 persons in patients aged 60–65 years versus 311 in those aged > 90 years) and was higher in men (166) than in women (150). The three disorders that had the strongest association with epilepsy were subarachnoid, intracerebral or intracranial hemorrhage (odds ratio [OR] = 3.31), stroke, including transient ischemic attack (OR = 2.32), and mental and behavioral disorders due to use of alcohol (OR = 2.20). In addition, there was a positive association between atypical neuroleptics and epilepsy (OR = 2.40). Conclusions The incidence of epilepsy was high and increased with age in elderly patients followed in general practices in Germany. Addressing identified risk factors may help reduce the risk of developing epilepsy.