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Epidemiologie der Epilepsie des höheren Lebensalters

Epidemiology of epilepsy in the elderly

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Zusammenfassung

Hintergrund

Die Lebenserwartung der Bevölkerung in entwickelten Ländern ist in den letzten 100 Jahren deutlich gestiegen. Infolgedessen wächst die Zahl älterer Menschen in der Bevölkerung und ihr Anteil steigt, da auch die Geburtenrate zurückgegangen ist. Gemäß Berechnungen der Statistischen Ämter des Bundes und der Länder wird der Anteil der über 60-Jährigen 2030 auf gut ein Drittel steigen. Mit wachsendem Alter steigt das Risiko chronischer Erkrankungen; dies gilt auch für epileptische Anfälle und Epilepsien.

Ziel der Arbeit

In einer Übersicht mit Schwerpunkt auf entwickelten Länder wird dargestellt, wie häufig Epilepsien im höheren Alter sind, wie viele Personen pro Jahr neu erkranken und welche Risikofaktoren im Alter die Wahrscheinlichkeit erhöhen, an einer Epilepsie zu erkranken.

Material und Methode

Hierzu wurde eine Pubmed-Abfrage durchgeführt.

Ergebnisse

Epidemiologische Studien belegen den deutlichen Anstieg der Rate der Neuerkrankungen von Älteren in den letzten 50 Jahren (Inzidenz). Der Bestand an Älteren mit Epilepsie (Prävalenz) hat sich hingegen nicht im selben Maß erhöht. Mögliche Gründe für diese Diskrepanz sind neben grundsätzlichen Problemen der Erfassung Älterer mit Epilepsie, eine erhöhte Mortalität im Alter und die erfolgreiche Behandlung. Risiken für die Altersepilepsie stellen zerebrovaskuläre Erkrankungen, v. a. Schlaganfälle, und degenerative Erkrankungen wie Demenz dar. Tumoren und psychiatrische Erkrankungen wie Psychosen, Depressionen und Substanzmittelmissbrauch bilden weitere, im Verhältnis jedoch geringere Risikofaktoren.

Schlussfolgerung

Insgesamt ist die Forschungslage, insbesondere in Deutschland, zu Altersepilepsien dürftig und muss – angesichts der demografischen Herausforderung – stärker in den Fokus genommen werden.

Abstract

Background

The life expectancy of the population in developed countries has increased significantly within the past 100 years. Due to this development the number of older people in the population is increasing and the proportion of the elderly has increased whereas the birth rate has declined. According to the official statistical offices in Germany the proportion of 60-year-olds will increase to one third of the population. With increasing age the risk of chronic diseases increases which is also true for epileptic seizures and epilepsy.

Aim

This article gives a review of studies focused on developed countries and the frequency of epilepsy in the elderly, the number of new cases per year and the risks of developing epilepsy in older age.

Material and methods

The study is based on a systematic search in Pubmed.

Results

Epidemiological studies show a significant increase in the rate of new cases of disease (incidence) in the elderly over the last 50 years. The prevalence of elderly people with epilepsy has, however, not increased to the same extent. In addition to the problem of detecting epilepsy in elderly, possible reasons for this discrepancy are an increased mortality in the elderly and successful treatment. Risks for developing epilepsy in older age are cerebrovascular diseases, especially stroke and degenerative diseases such as dementia. Tumors and psychiatric disorders, such as psychosis, depression and substance abuse are also risk factors but with a less significant impact.

Conclusion

Overall, the state of research on epilepsy in the elderly is poor, particularly in Germany. In the light of the demographic challenge, more emphasis should be placed on research into epilepsy in the elderly.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Pfäfflin und T.W. May geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Gesellschaft für Epilepsieforschung, Epilepsie-Zentrum Bethel, Maraweg 21, 33617, Bielefeld, Deutschland

    M. Pfäfflin M.A. Bioethik & T.W. May

  2. Krankenhaus Mara, Epilepsie-Zentrum Bethel, Bielefeld, Deutschland

    M. Pfäfflin M.A. Bioethik

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  1. M. Pfäfflin M.A. Bioethik
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  2. T.W. May
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Correspondence to M. Pfäfflin M.A. Bioethik.

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Pfäfflin, M., May, T. Epidemiologie der Epilepsie des höheren Lebensalters. Z. Epileptol. 27, 246–252 (2014). https://doi.org/10.1007/s10309-014-0401-3

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