Dr. Evan Thacker’s new research shows a greater cognitive decline in older adults with epilepsy when vascular risk factors are also present
“When we think about the health of older people in our society, one of the most important things for them is the health of their brain,” Dr. Evan Thacker says.
Epilepsy is a neurological disorder involving seizures, which are episodes of abnormal electrical signaling in the brain. While epilepsy is commonly onset before age 20, it is most prevalent among those ages 70 and older. Thacker and his colleagues conducted research on cognitive decline among individuals who had both epilepsy and a vascular risk factor–a factor that increases the risk for blood vessel disease (e.g., hypertension, smoking, and heart disease). Cognitive decline affects the brain’s functions of thinking, memory, and processing speed. He hopes his findings will enact further research to protect the brain health of older individuals with epilepsy.
Vascular risk factors like hypertension, smoking, and diabetes put individuals at risk for faster cognitive decline and earlier onset dementia. Thacker and colleagues' previous research has shown that individuals with epilepsy experience similar cognitive effects. However, little research existed regarding the overlap between epilepsy in combination with one of these risk factors. This gap motivated Thacker to discover vascular risk factors associated with greater-than-expected cognitive decline among individuals with epilepsy.
Thacker’s findings show that epilepsy is associated with faster cognitive decline when certain vascular risk factors are present. The cognitive decline observed from the interaction between epilepsy and hypertension, for example, was almost twice the decline that occurred in people who did not suffer from either disease.
Additionally, vascular risk factors including stroke, high triglyceride levels, smoking, and coronary heart disease were all associated with a more rapid cognitive decline when combined with epilepsy.
Individuals with epilepsy are also more heavily burdened with vascular risk factors than the average person. Coupled with Thacker’s findings that vascular risk factors have a greater negative effect on the brain for people with epilepsy, monitoring for these factors may be more important than previously realized.
Modifying lifestyle can prevent some of these factors such as hypertension, coronary heart disease, and smoking. Thacker explains that proper diet and exercise promote healthy blood vessels and ultimately brain health.
“When people have epilepsy and they’re meeting with an epilepsy specialist doctor, that doctor’s main concern is likely to be reducing seizures. Our work suggests that the epilepsy doctor and patient may benefit from paying attention to the risk of having other bad things happen in their brain like having a stroke or getting dementia, both of which are tied to the health of the blood vessels.”
Thacker was surprised that his team did not find additional associations between epilepsy and certain vascular risk factors, but he attributes that to the study's relatively small sample size. Their recent study included about 200 people with epilepsy compared with about 5,000 people without epilepsy. In order to advance this line of research that links epilepsy with vascular health, Thacker and his colleagues have recently acquired funding from the National Institutes of Health for a much larger study, to be conducted for 5 years. This study is expected to involve about 1,600 people with epilepsy compared with 40,000 without.
Thacker hopes that this newly-funded research will advance our knowledge and is eager for the help new data could provide to aging epilepsy patients.
“If we find stronger evidence that epilepsy plus vascular risk factors increase your risk of cognitive decline, dementia, and stroke,” Thacker remarks, “that could lead to recommendations for doctors to pay more attention to the overall health of the brain of epilepsy patients in addition to seizure prevention.”
Students Emma Hoyt and Rebekah Hafen worked alongside Thacker and were published as coauthors in Neurology.
Additionally, Hafen presented their findings at the 2022 BYU Gerontology Conference with Rebecca Cromar and Margo Memmott.
