Quality of life and psychosocial aspects of elderly people with epilepsy

Background. Due to demographic changes and a high incidence of epilepsy in older people, the number of elderly people with epilepsy is increasing. However, only few studies have reported on the quality of life (QoL) and related aspects in this patient group. Aim. A review of studies on the impact of epilepsy on QoL and related aspects in the elderly is given. Material and methods. The review is based on a selection of Pubmed-listed articles and an own study on QoL in elderly people with epilepsy by making a distinction between elderly people with late-onset epilepsy and those with long-term epilepsy. Results and discussion. Elderly people with epilepsy did not necessarily experience more restrictions due to epilepsy than younger adults with epilepsy. Younger adults experienced greater restrictions with respect to employment and family but reported a higher overall QoL and more activities in social life and leisure. With regard to restrictions due to epilepsy and overall QoL, elderly people with long-term epilepsy did not essentially differ from elderly people with late-onset epilepsy. In general, the overall QoL and restrictions in daily life due to epilepsy are affected by the adverse effects of antiepileptic drugs, seizure-related variables, comorbidities and dependence on help from others whereas age and age at onset of epilepsy have no or only a subordinate influence on epilepsy-related impairments. Elderly people with epilepsy have greater anxiety for injuries and accidents, especially of falls or fractures due to seizures than younger adults. The results indicate that elderly people with long-term epilepsy also have greater fears of stigmatization but the results of studies on stigma perceived by the elderly are not consistent. Conclusion. Further studies are necessary to investigate the QoL especially in very old patients with epilepsy and to investigate the impact of comorbidities in more detail.