Factors associated with global cognitive impairment in epilepsy patients: a cross-sectional study in Mataram, Indonesia
BACKGROUND Cognitive impairment is a major complication of epilepsy. This study aimed to investigate the factors associated with the prevalence of cognitive impairment in patients with epilepsy in Mataram, Indonesia.
METHODS This cross-sectional study involved 155 consecutive outpatients with epilepsy at Mataram General Hospital, Mutiara Sukma Mental Hospital, and Siti Hajar Hospital, Mataram, Indonesia between September 2017 and August 2020. Data on the patient’s demographic characteristics, epilepsy, treatment variables, and global cognitive status were collected. The association between the determinants of epilepsy-associated cognitive impairment and the prevalence of epilepsy-associated global cognitive impairment was analyzed using logistic regression.
RESULTS The prevalence of epilepsy-associated global cognitive impairment was 83.9% and related to a low level of education (odds ratio [OR] = 5.24, 95% confidence interval [CI] = 1.93–14.20), early age at onset (OR = 7.85, 95% CI = 0.82–33.79), and long duration of epilepsy (OR = 8.47, 95% CI = 1.95–36.88).
CONCLUSIONS A high prevalence of epilepsy-associated global cognitive impairment was observed in Mataram and was associated with a low level of education, early age at onset, and long duration of epilepsy.
Mula M. Cognitive dysfunction in patients with epilepsy: focus on clinical variables. Future Neurol. 2015;10(1):41-8. https://doi.org/10.2217/fnl.14.65
Helmstaedter C, Witt JA. Epilepsy and cognition - a bidirectional relationship? Seizure. 2017;49:83-9. https://doi.org/10.1016/j.seizure.2017.02.017
Espinosa-Jovel C, Toledano R, Aledo-Serrano Á, García-Morales I, Gil-Nagel A. Epidemiological profile of epilepsy in low income populations. Seizure. 2018;56:67-72. https://doi.org/10.1016/j.seizure.2018.02.002
Fiest KM, Sauro KM, Wiebe S, Patten SB, Kwon CS, Dykeman J, et al. Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies. Neurology. 2017;88(3):296-303. https://doi.org/10.1212/WNL.0000000000003509
Harahap HS, Rizki M, Nurfadia MF, Nabiela AS, Sari IP. Characteristics of cognitive status of epilepsy patients treated with monotherapy of first-generation antiepileptic drugs. Malaysian J Public Health Med. 2020;20(2):11-8. https://doi.org/10.37268/mjphm/vol.20/no.2/art.193
Harun Y, Handayani S, Nindela R. Correlation of cognitive functions and location of focal epilepsy in RSUP Dr. Mohammad Hoesin Palembang. Majalah Kedokteran Sriwijaya. 2021;53(1):8-12. https://doi.org/10.32539/mks.v53i1.13215
Lestari ND, Rizkidawati, Shafira CP, Suherman, Mutiawati E. Factors affecting the mini-mental state examination (MMSE) score in the epilepsy patients in Aceh, Indonesia. Bali Med J. 2020;9(1):185-8. https://doi.org/10.15562/bmj.v9i1.1736
Li N, Li J, Chen Y, Chu C, Zhang X, Zhong R, et al. One-year analysis of risk factors associated with cognitive impairment in newly diagnosed epilepsy in adults. Front Neurol. 2020;11:594164. https://doi.org/10.3389/fneur.2020.594164
Lodhi S, Agrawal N. Neurocognitive problems in epilepsy. Adv Psychiatr Treat. 2012;18:232-40. https://doi.org/10.1192/apt.bp.110.007930
Wang L, Chen S, Liu C, Lin W, Huang H. Factors for cognitive impairment in adult epileptic patients. Brain Behav. 2020;10(1):e01475. https://doi.org/10.1002/brb3.1475
Sharma S, Nehra A, Tripathi M. Applicability of compensatory cognitive training in epilepsy to low resource and literacy settings: a focused review. Neurol India. 2021;69(3):717-23. https://doi.org/10.4103/0028-3886.319233
Landi S, Petrucco L, Sicca F, Ratto GM. Transient cognitive impairment in epilepsy. Front Mol Neurosci. 2019;11:458. https://doi.org/10.3389/fnmol.2018.00458
Holmes GL. Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord. 2015;17(2):101-16. https://doi.org/10.1684/epd.2015.0739
Leeman-Markowski BA, Schachter SC. Treatment of cognitive deficits in epilepsy. Neurol Clin. 2016;34(1):183-204. https://doi.org/10.1016/j.ncl.2015.08.008
Hardianto AM, Tjahjadi B, Narsa IM. Human Development Index (HDI) as a planning plan for dealing globalization of Asean Economic Society (MEA) in Indonesia. Proceeding of The ICECRS. 2017;1(2):108-15. https://doi.org/10.21070/picecrs.v1i2.1444
Rambe AS, Fitri FI. Correlation between the Montreal Cognitive Assessment-Indonesian version (Moca-INA) and the Mini-Mental State Examination (MMSE) in elderly. Open Access Maced J Med Sci. 2017;5(7):915-9. https://doi.org/10.3889/oamjms.2017.202
Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9. https://doi.org/10.1111/j.1532-5415.2005.53221.x
Coen RF, Robertson DA, Kenny RA, King-Kallimanis BL. Strengths and limitations of the MoCA for assessing cognitive functioning: findings from a large representative sample of Irish older adults. J Geriatr Psychiatry Neurol. 2016;29(1):18-24. https://doi.org/10.1177/0891988715598236
Saczynski JS, Inouye SK, Guess J, Jones RN, Fong TG, Nemeth E, et al. The Montreal Cognitive Assessment: creating a crosswalk with the Mini-Mental State Examination. J Am Geriatr Soc. 2015;63(11):2370-4. https://doi.org/10.1111/jgs.13710
Tedrus GM, Passos ML, Vargas LM, Menezes LE. Cognition and epilepsy: cognitive screening test. Dement Neuropsychol. 2020;14(2):186-93. https://doi.org/10.1590/1980-57642020dn14-020013
Mazur-Mosiewicz A, Carlson HL, Hartwick C, Dykeman J, Lenders T, Brooks BL, et al. Effectiveness of cognitive rehabilitation following epilepsy surgery: current state of knowledge. Epilepsia. 2015;56(5):735-44. https://doi.org/10.1111/epi.12963
Kehyayan V, Hirdes JP. Care needs and health care burden of persons with epilepsy receiving home care services. Home Health Care Manag Pract. 2019;31(1):42-50. https://doi.org/10.1177/1084822318806291
Holbein CE, Smith AW, Peugh J, Modi AC. Allocation of treatment responsibility in adolescents with epilepsy: associations with cognitive skills and medication adherence. J Pediatr Psychol. 2019;44(1):72-83. https://doi.org/10.1093/jpepsy/jsy006
Berg AT, Zelko FA, Levy SR, Testa FM. Age at onset of epilepsy, pharmacoresistance, and cognitive outcomes: a prospective cohort study. Neurology. 2012;79(13):1384-91. https://doi.org/10.1212/WNL.0b013e31826c1b55
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