Sun, James J;
Watkins, Lance;
Henley, William;
Laugharne, Richard;
Angus-Leppan, Heather;
Sawhney, Indermeet;
Shahidi, Meissam Moghaddassian;
... Shankar, Rohit; + view all
(2023)
Mortality risk in adults with intellectual disabilities and epilepsy: an England and Wales case–control study.
Journal of Neurology
, 270
pp. 3527-3536.
10.1007/s00415-023-11701-6.
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Abstract
BACKGROUND: People with epilepsy (PWE) and people with intellectual disabilities (ID) both live shorter lives than the general population and both conditions increase the risk of death further. We aimed to measure associations between certain risk factors for death in PWE and ID. METHODS: A retrospective case–control study was conducted in ten regions in England and Wales. Data were collected on PWE registered with secondary care ID and neurology services between 2017 and 2021. Prevalence rates of neurodevelopmental, psychiatric and medical diagnoses, seizure frequency, psychotropic and antiseizure medications (ASM) prescribed, and health activity (epilepsy reviews/risk assessments/care plans/compliance etc.) recorded were compared between the two groups. RESULTS: 190 PWE and ID who died were compared with 910 living controls. People who died were less likely to have had an epilepsy risk assessment but had a greater prevalence of genetic conditions, older age, poor physical health, generalized tonic–clonic seizures, polypharmacy (not ASMs) and antipsychotic use. The multivariable logistic regression for risk of epilepsy-related death identified that age over 50, medical condition prevalence, antipsychotic medication use and the lack of an epilepsy review in the last 12 months as associated with increased risk of death. Reviews by psychiatrists in ID services was associated with a 72% reduction in the odds of death compared neurology services. CONCLUSIONS: Polypharmacy and use of antipsychotics may be associated with death but not ASMs. Greater and closer monitoring by creating capable health communities may reduce the risk of death. ID services maybe more likely to provide this holistic approach.
Type: | Article |
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Title: | Mortality risk in adults with intellectual disabilities and epilepsy: an England and Wales case–control study |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1007/s00415-023-11701-6 |
Publisher version: | https://doi.org/10.1007/s00415-023-11701-6 |
Language: | English |
Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
Keywords: | Developmental disabilites, Premature mortality, Seizures, Multi-morbidity, Antipsychotics prescribing, Neurodevelopment |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research |
URI: | https://discovery.ucl.ac.uk/id/eprint/10171971 |
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