Epidemiology of epilepsy in older adults with an intellectual disability in Ireland: associations and service implications.
One in three older Irish adults with ID has active epilepsy yet almost none see a neurologist.
01Research in Context
What this study did
McCarron et al. (2014) mailed a short survey to every Irish agency that houses adults with intellectual disability.
They asked about every person aged 50-plus: Do they have epilepsy? Do they still have seizures? Who manages their care?
In total, 402 older adults with ID were screened across 24 counties.
What they found
One in three older adults with ID had epilepsy.
Most of them kept having seizures even with medicine.
Only a handful saw an epilepsy specialist or had a recent EEG.
How this fits with other research
Hithersay et al. (2014) looked at every carer-led health program for adults with ID and found none that work. Their review covers epilepsy monitoring, so it backs the Irish finding that no good carer-led seizure-tracking model exists yet.
Gaily et al. (1998) ran a similar mail survey and found that adults with ID and epilepsy also have more night waking. Together the two surveys show epilepsy is both common and linked to other hidden issues.
Guest et al. (2013) used the same cross-sectional design in Dutch older adults with ID and found one in five had undiagnosed artery disease. Both papers end with the same warning: routine annual checks must include these overlooked conditions.
Why it matters
If you support older adults with ID, add two quick questions to your intake: “Any seizures?” and “Last neurology visit?” When the answer is “yes” and “never,” you have the data to push for a referral. This tiny step can stop seizures that are quietly hurting quality of life.
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02At a glance
03Original abstract
There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were examined. It was found that prevalence was high (30.7%); but declined as people aged. Those with epilepsy were less likely to live with family, independently or in community settings, rates of refractory epilepsy were high and, despite medication over half of those with epilepsy still reported experiencing seizures. Given these findings, people with ID and their careers have considerable needs for information about epilepsy management, and for support from specialist ID and epilepsy services.
American journal on intellectual and developmental disabilities, 2014 · doi:10.1352/1944-7558-119.3.253