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A study published in Neurology on October 14 found that epilepsy was associated with a higher likelihood of young-onset dementia in data from France and Sweden. In a French follow-up, 2.2% of people newly diagnosed with epilepsy developed young-onset dementia over 10 years, compared with 0.2% of people without epilepsy; the study does not show that epilepsy causes dementia.
A study published October 14 in Neurology found that people with epilepsy were more likely to be diagnosed with young-onset dementia than people without epilepsy in analyses using health data from France and Sweden. The researchers stressed that the findings show an association, not that epilepsy directly causes dementia, and that the absolute risk was low.
The researchers used two approaches. In France and Sweden, they compared people diagnosed with young-onset dementia with people of the same age and sex who did not have dementia, then checked for an epilepsy diagnosis or use of epilepsy medication in the preceding decade. The French analysis included 11,360 people with dementia and 113,600 comparison participants. The Swedish analysis included 16,433 people with dementia and 164,330 comparison participants.
In France, 12.5% of people with dementia had an epilepsy diagnosis, compared with 1.2% of those without dementia. Use of epilepsy medication was also more common among people with dementia: 27.3%, compared with 10.3% in the comparison group. The report said the pattern was similar in Sweden; it did not provide the corresponding Swedish percentages in the supplied study summary.
The second approach followed French participants over time. It included 12,901 people newly diagnosed with epilepsy in 2008, 64,083 people with existing epilepsy and 129,010 people without epilepsy. Over as long as 10 years, young-onset dementia was diagnosed in 2.2% of the newly diagnosed group, 1.7% of the existing-epilepsy group and 0.2% of the group without epilepsy. After adjusting for factors including stroke, mood disorders and traumatic brain injury, newly diagnosed epilepsy was associated with six times the likelihood of young-onset dementia, while existing epilepsy was associated with a 74% higher likelihood.
Implications for Epilepsy Care
The findings add evidence about a possible link between epilepsy and dementia diagnosed before age 65, an area where the study authors said evidence had been limited. For people receiving epilepsy care, the results may support attention to cognitive health and to risk factors that can be modified. The study author specifically pointed to cardiovascular risks such as high blood pressure and said earlier assessment of cognitive risks could benefit some patients.
Those implications should be read alongside the absolute figures. In the French follow-up, most participants with epilepsy were not diagnosed with young-onset dementia during the period studied. The comparison also does not establish that preventing or treating epilepsy would prevent dementia. The study identifies a relationship that may inform care and future research, while leaving the cause of that relationship unresolved.
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How Researchers Compared Groups
Young-onset dementia, also called early-onset dementia, refers to dementia that develops before age 65. The study, titled “Association between epilepsy and young-onset dementia,” appeared in the medical journal Neurology. Its authors used national health databases in France and Sweden for the comparisons between people with and without dementia, and French data for the follow-up of people with epilepsy.
The two methods address the association from different directions: one looked backward from dementia diagnoses to earlier epilepsy records or medication use, while the other tracked people with epilepsy and a comparison group for later dementia diagnoses. The report described prior research linking epilepsy with late-onset dementia, but said evidence on young-onset dementia had been limited. The work was supported by the French National Research Agency.
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Limits of the Available Data
The findings do not show whether epilepsy contributes to dementia, whether another factor contributes to both, or whether other explanations account for some of the association. Although the researchers adjusted for several factors, the report does not establish a direct cause-and-effect relationship. It also does not show that dementia prevention measures will reduce diagnoses among people with epilepsy.
The researchers lacked detailed information on the type or cause of dementia and on the type of epilepsy. The study relied on data from France and Sweden, both high-income countries with universal health care coverage, so its results may not apply in other health systems or populations. The supplied report does not give detailed Swedish percentages or describe how individual diagnoses were clinically assessed.
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Questions for Future Research
The study report does not identify a scheduled follow-up study or a specific next research milestone. Further work would need to clarify which types and causes of epilepsy or dementia may be involved, and whether the observed association appears in other countries and health systems. Researchers would also need to examine whether particular modifiable risk factors help explain the pattern.
For now, the authors’ stated implication is that epilepsy care may include earlier attention to cognitive risks and management of modifiable factors such as high blood pressure. The study does not prescribe a prevention plan or establish that any particular intervention changes dementia risk. Its findings provide a basis for further research and consideration in clinical care.
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Key Questions
Does epilepsy cause young-onset dementia?
The study found an association, but it does not prove that epilepsy directly causes dementia. The reasons for the relationship remain unclear.
How common was young-onset dementia among participants with epilepsy?
In the French follow-up, 2.2% of people newly diagnosed with epilepsy developed young-onset dementia over as long as 10 years. The figure was 1.7% among people with existing epilepsy and 0.2% among those without epilepsy.
What does young-onset dementia mean?
It refers to dementia that develops before age 65. It is also sometimes called early-onset dementia.
What factors did the researchers account for?
The adjusted analysis included factors that could affect dementia likelihood, including stroke, mood disorders and traumatic brain injury. Adjustment does not rule out all other possible explanations.
Can the results be applied everywhere?
The study used health data from France and Sweden. Its authors noted that findings from these high-income countries with universal health care may not apply to other settings.
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