Epilepsy and aging

Epilepsy is a common condition of the brain in which a person experiences recurrent, unprovoked seizures. It most often begins in childhood or in older adulthood, although it can start at any age. People over the age of 65 have the highest rate of new-onset epilepsy of any age group, making up a large share of newly diagnosed cases.

Because populations are aging, the number of older adults living with epilepsy is rising, along with the need to understand how the condition affects this group. The chance of having a seizure increases noticeably after the age of 60, often because of other neurological conditions such as dementia or stroke.

There are many causes of epilepsy and seizures#

Common causes of epilepsy and seizures in older people include:

• Stroke
• Brain injury
• Brain tumour
• Degenerative conditions such as dementia
• Other medical conditions that affect how the brain works
• Lifestyle-related factors such as alcohol, smoking, sleep deprivation, stress and depression

About half of all seizures in older adults have no identifiable cause.

The cause of your seizures should be investigated#

If someone is having seizures, it is very important that the cause is properly investigated. This helps determine which types of treatment and support are most suitable.

Epilepsy can be hard to diagnose in later life. Seizures in older people are sometimes mistakenly assumed to be part of another condition, such as dementia, or simply part of ageing.

Everyone’s experience of a seizure is different. Some people have seizures every day, while others have them only rarely or when they miss a dose of their medication. People are not always aware that they are having a seizure.

For this reason, it is important that friends, family and carers notice any changes in behaviour.

What to watch for and note#

If you observe changes in someone you care for, such as possible seizures, confusion or cognitive impairment:

• Make a note of when symptoms happen. For example, do they occur in particular postures or alongside specific movements?
• Note how long any periods of confusion last.
• Encourage the person to see their doctor.

Only a specialist can diagnose epilepsy, but accurate, thorough observations from those around the person can be very helpful in reaching a diagnosis. A simple witness statement that records what happened during an episode can support this process.

Diagnosis in older people#

Diagnosis usually draws on several sources, including:

• Observations from friends, family and carers
• Medical history
• Medical tests, including blood tests
• EEG (electroencephalogram)
• CT scan (computed tomography)
• MRI

Treatment#

Deciding on the right treatment is important and needs specialist expertise. Older people often have other health conditions that require medication, and a specialist will take these factors into account when developing a treatment plan.

Treatment options may include:

• Anti-seizure medication (ASM)
• Emergency medication
• Dietary approaches
• Surgery

Epilepsy and aged care#

People in their later years who live in residential aged care are reported to have a higher rate of epilepsy than the wider community. In older people, seizure activity and any related changes in behaviour can be subtle.

It is important that aged care workers and carers know what to look for, can recognise the signs of seizure activity and can document what they see. Resources developed specifically for older people, their families and carers, and for aged care staff, can help with this.

Key points#

• Epilepsy is a common condition of the brain in which a person experiences recurrent unprovoked seizures.
• Epilepsy most commonly begins in childhood or in older adulthood, although it can begin at any age.
• There are many causes of epilepsy and seizures.
• The cause of your seizures should be investigated.
• Common causes of epilepsy in older people include medical conditions affecting brain function.

Where to get help#