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Globally, as populations age there will be challenges and opportunities to deliver optimal health care to senior citizens. Epilepsy, a condition characterised by spontaneous recurrent seizures, is common in older adults (aged >65 years) and yet has received comparatively little attention in this age group. In this Review, we evaluate the underlying causes of epilepsy in older people, explore difficulties in establishing a diagnosis of epilepsy in this population, discuss appropriate antiseizure medications, and evaluate potential surgical treatment options. We consider cognitive, psychological, and psychosocial comorbidities and the effect that epilepsy might have on an older person's broader social or care network in high-income versus middle-income and low-income countries. We emphasise the need for clinical trials to be more inclusive of older people with epilepsy to help inform therapeutic decision making and discuss whether measures to improve vascular risk factors might be an important strategy to reduce the probability of developing epilepsy.

Original publication

DOI

10.1016/S0140-6736(19)33064-8

Type

Journal article

Journal

Lancet

Publication Date

29/02/2020

Volume

395

Pages

735 - 748

Keywords

Aged, Alzheimer Disease, Anticonvulsants, Autoimmune Diseases of the Nervous System, Brain Neoplasms, Cerebrovascular Disorders, Clinical Decision-Making, Clinical Trials as Topic, Cognitive Dysfunction, Comorbidity, Developed Countries, Developing Countries, Epilepsy, Humans, Incidence, Mental Disorders, Neurosurgical Procedures, Prevalence, Status Epilepticus, Sudden Unexpected Death in Epilepsy