Risk of seizures and subclinical epileptiform activity in patients with dementia: A systematic review and meta-analysis

• Published in: Ageing research reviews 2021-12, Vol.72, p.101478-101478, Article 101478
• Main Authors: Zhao, Bing, Shen, Ling-Xiao, Ou, Ya-Nan, Ma, Ya-Hui, Dong, Qiang, Tan, Lan, Yu, Jin-Tai
• Format: Article
• Language: English
• Subjects: Alzheimer Disease - epidemiology; Alzheimer’s disease; Dementia; Dementia, Vascular; Epidemiology; Frontotemporal Dementia; Humans; Lewy Body Disease; Meta-analysis; Seizures; Seizures - epidemiology
• ISSN: 1568-1637; 1872-9649
• DOI: 10.1016/j.arr.2021.101478

Seizures and subclinical epileptiform activity are common yet easily overlooked among demented patients. We aimed to investigate their epidemiological characteristics in patients with dementia from various aspects. We retrieved relevant observational studies from PubMed and Embase Library until March 2021. Pooled estimate effects were calculated using random-effects models. This study is registered with PROSPERO, number CRD42020200949. Of the 19144 identified studies, 27 were eligible for inclusion. The pooled period prevalence rates of seizures were 4.86% (95%CI: 3.43–6.51%), 2.68% (95%CI: 2.13–3.28%), 2.81% (95%CI: 2.02–3.71%）and 7.13% (95%CI: 2.67–13.14%) among patients with Alzheimer’s disease (AD), Dementia of Lewy Body (DLB), Frontotemporal dementia (FTD) and Vascular dementia (VaD), respectively. The pooled incidence rate of seizures was [8.4 (95%CI: 4.2–12.7) per 1000 person-years] in AD patients. And the pooled relative risk of seizures in patients with AD was 3.35 (95%CI: 2.69–4.19). Besides, the pooled cumulative incidence rate and prevalence rate of subclinical epileptiform activity among AD patients were [21.41% (95%CI: 0.001–63.60%)] and 9.73% (95%CI: 0.26–28.38%), respectively. The accurate rates of seizures and subclinical epileptiform activities in the four major dementia types are high. Besides, patients with AD are likely at a higher risk of seizures. •Patients with AD were at a higher risk of seizures compared with non-AD controls.•The prevalence rate of seizures was high in VaD, FTD and DLB.•Patients with AD were at a high rate of subclinical epileptiform activity.•Understanding the relevant rate was informative to precision medicine for dementia.