SUDEP underestimated as a cause of mortality in older adults with epilepsy

Ifrah Zawar, MD, University of Virginia School of Medicine, Charlottesville, VA, discusses the impact of epilepsy on mortality in older adults. While all-cause mortality is known to be higher in people with epilepsy than those without, these mortality studies have not commonly focused on older adults. It is thought that epilepsy as a cause of death in older adults is often overlooked. Causes of death in persons with late-onset epilepsy are most commonly reported as stroke, cardiovascular conditions, and dementia, with very few cases directly attributed to seizure-related causes. However, in studies involving epileptologists, a much higher rate of seizure-associated deaths and SUDEP has been noted. Given the prevalence of comorbidities in older adults with epilepsy, other common causes of death in this population are often assumed responsible, even without confirmatory evidence. Dr Zawar highlights the importance of obtaining a seizure history in these patients and taking a more comprehensive view when determining cause of death. This interview took place during the American Epilepsy Society (AES) 2023 Annual Meeting congress in Orlando, FL.

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