A bidirectional association between cognitive ability in young adulthood and epilepsy: a population-based cohort study

A bidirectional association between cognitive ability in young adulthood and epilepsy: a... AbstractAimTo investigate the bidirectional association between cognitive ability in young adulthood and epilepsy.MethodsThis cohort study included 1 159 076 men enrolled in the mandatory conscription board examination from the Danish Conscription Database (DCD; 658 465 men examined 1957–84), the Danish Defence Personnel Organization Database (DPOD; 216 509 men examined 1987–2005) and the Danish Conscription Registry (DCR; 284 102 men examined 2006-15). A supplementary analysis included 14 814 female volunteers. Cognitive ability was measured at conscription, and epilepsy was ascertained by physician diagnoses in the Danish National Patient Registries 1977–2016 [using International Classification of Diseases (ICD) codes: ICD-8-345; ICD-10-G40-G41]. Differences in cognitive ability in relation to epilepsy status at the time of conscription (age 19) were calculated using linear regression. The risk of epilepsy associated with cognitive ability was estimated using Cox regression models, split at age at follow-up (40 and 60 years) and adjusted for year of birth, cerebrovascular disease, traumatic brain injury and education.ResultsIn all, 5097 (1.0%) men from the DPOD and DCR were diagnosed with epilepsy before conscription, and they had about 0.25 standard deviation (SD) lower cognitive scores than men without epilepsy. The largest difference in cognition was seen for those with the largest number of hospital contacts. A total of 22 364 (1.9%) men developed epilepsy, and cognitive ability was inversely associated with the risk of epilepsy. With the end of follow-up at age 40 years, the adjusted hazard ratio (HR)per SD increase was 0.75 (95% confidence interval = 0.73–0.77). The association attenuated with increasing age at diagnosis. The findings were replicated in female conscripts.ConclusionsThe cognitive impairment seen in adults with epilepsy seems to reflect combined effects of epileptic processes and lower premorbid cognitive ability. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Epidemiology Oxford University Press

A bidirectional association between cognitive ability in young adulthood and epilepsy: a population-based cohort study

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Publisher
Oxford University Press
Copyright
© The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
ISSN
0300-5771
eISSN
1464-3685
D.O.I.
10.1093/ije/dyy018
Publisher site
See Article on Publisher Site

Abstract

AbstractAimTo investigate the bidirectional association between cognitive ability in young adulthood and epilepsy.MethodsThis cohort study included 1 159 076 men enrolled in the mandatory conscription board examination from the Danish Conscription Database (DCD; 658 465 men examined 1957–84), the Danish Defence Personnel Organization Database (DPOD; 216 509 men examined 1987–2005) and the Danish Conscription Registry (DCR; 284 102 men examined 2006-15). A supplementary analysis included 14 814 female volunteers. Cognitive ability was measured at conscription, and epilepsy was ascertained by physician diagnoses in the Danish National Patient Registries 1977–2016 [using International Classification of Diseases (ICD) codes: ICD-8-345; ICD-10-G40-G41]. Differences in cognitive ability in relation to epilepsy status at the time of conscription (age 19) were calculated using linear regression. The risk of epilepsy associated with cognitive ability was estimated using Cox regression models, split at age at follow-up (40 and 60 years) and adjusted for year of birth, cerebrovascular disease, traumatic brain injury and education.ResultsIn all, 5097 (1.0%) men from the DPOD and DCR were diagnosed with epilepsy before conscription, and they had about 0.25 standard deviation (SD) lower cognitive scores than men without epilepsy. The largest difference in cognition was seen for those with the largest number of hospital contacts. A total of 22 364 (1.9%) men developed epilepsy, and cognitive ability was inversely associated with the risk of epilepsy. With the end of follow-up at age 40 years, the adjusted hazard ratio (HR)per SD increase was 0.75 (95% confidence interval = 0.73–0.77). The association attenuated with increasing age at diagnosis. The findings were replicated in female conscripts.ConclusionsThe cognitive impairment seen in adults with epilepsy seems to reflect combined effects of epileptic processes and lower premorbid cognitive ability.

Journal

International Journal of EpidemiologyOxford University Press

Published: Aug 1, 2018

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