Use of antiepileptic drugs and dementia risk: An analysis of Finnish Health Register and German Health Insurance Data

• Autores: Heidi Taipale, Willy Gomm, Karl Broich, Wolfgang Maier, Anna Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Britta Haenisch
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 6, 2018, págs. 1123-1129
• Idioma: inglés
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• Resumen

  • Objectives To evaluate the association between regular antiepileptic drug (AED) use and incident dementia.

    Design Case‐control analysis.

    Setting Finnish public health register and German health insurance data.

    Participants Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Finnish data, N=70,718) were matched with up to four control persons without dementia.

    Measurements We analyzed the association between regular AED use and dementia. To address potential protopathic bias, a lag time of 2 years between AED use and dementia diagnosis was introduced. Odds ratios (ORs) were calculated by applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy.

    Results Regular AED use was more frequent in individuals with dementia than controls. Regular use of AEDs was associated with a significantly greater risk of incident dementia (adjusted OR=1.28, 95% confidence interval (CI)=1.14–1.44) and AD (adjusted OR=1.15, 95% CI=1.09–1.22) than no AED use. We also detected a trend toward greater risk of dementia with higher exposure. When AEDs with and without known cognitive adverse effects (CAEs) were compared, a significantly greater risk of dementia was observed for substances with known CAEs (dementia: OR=1.59, 95% CI=1.36–1.86; AD: OR=1.19, 95% CI=1.11–1.27).

    Conclusion AEDs, especially those with known CAEs, may contribute to incident dementia and AD in older persons.