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J Am Geriatr Soc. 2018 Jul;66(6):1123-1129. doi: 10.1111/jgs.15358. Epub 2018 Mar 22.

Use of Antiepileptic Drugs and Dementia Risk-an Analysis of Finnish Health Register and German Health Insurance Data.

Author information

1
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
2
Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
3
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
4
German Center for Neurodegenerative Diseases, Bonn, Germany.
5
Federal Institute for Drugs and Medical Devices, Bonn, Germany.
6
Department of Psychiatry, University of Bonn, Bonn, Germany.
7
Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.
8
Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.

Abstract

OBJECTIVES:

To evaluate the association between regular antiepileptic drug (AED) use and incident dementia.

DESIGN:

Case-control analysis.

SETTING:

Finnish public health register and German health insurance data.

PARTICIPANTS:

Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Finnish data, N=70,718) were matched with up to four control persons without dementia.

MEASUREMENTS:

We analyzed the association between regular AED use and dementia. To address potential protopathic bias, a lag time of 2 years between AED use and dementia diagnosis was introduced. Odds ratios (ORs) were calculated by applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy.

RESULTS:

Regular AED use was more frequent in individuals with dementia than controls. Regular use of AEDs was associated with a significantly greater risk of incident dementia (adjusted OR=1.28, 95% confidence interval (CI)=1.14-1.44) and AD (adjusted OR=1.15, 95% CI=1.09-1.22) than no AED use. We also detected a trend toward greater risk of dementia with higher exposure. When AEDs with and without known cognitive adverse effects (CAEs) were compared, a significantly greater risk of dementia was observed for substances with known CAEs (dementia: OR=1.59, 95% CI=1.36-1.86; AD: OR=1.19, 95% CI=1.11-1.27).

CONCLUSION:

AEDs, especially those with known CAEs, may contribute to incident dementia and AD in older persons.

KEYWORDS:

antiepileptic drugs; dementia; older adults; risk factor

PMID:
29566430
DOI:
10.1111/jgs.15358

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