SEIZURES AND OVERALL SURVIVAL IN EARLY-ONSET DEMENTIA: A RETROSPECTIVE EHR-BASED COHORT STUDY
Author(s)
Guanming Chen, Ph.D.1, Zhigang Xie, Ph.D.2;
1University of California San Francisco, San Francisco, CA, USA, 2University of Florida, Department of Health Services Research, Management and Policy, Gainesville, FL, USA
1University of California San Francisco, San Francisco, CA, USA, 2University of Florida, Department of Health Services Research, Management and Policy, Gainesville, FL, USA
OBJECTIVES: Seizures are a recognized complication of dementia in older adults, but seizure conditions are understudied among patients with early-onset dementia (EOD; onset before age 65 years).
METHODS: We conducted a retrospective longitudinal cohort study using data from the University of California, San Francisco Clinical Data Warehouse (UCSF CDW) from 2015 to 2025. Adult individuals with a documented diagnosis of dementia who were younger than 65 years during the study period were included in the analytic cohort. Patients were followed from cohort entry until death or the last date of cohort entry (Jun. 30, 2025), with censoring at the time of loss to follow-up. Descriptive analyses were used to estimate the prevalence of seizures. Multivariable Cox proportional hazard models were applied to examine the association between seizures and overall survival (OS).
RESULTS: A total of 2,633 patients with EOD were identified. The cohort was predominately aged 55-64 years (68.8%), male (53%), non-Hispanic White (53%), publicly insured (53.6%), and with a Charlson Comorbidity Index (CCI) of 1 to 2 (63.3%). Overall, 765 (29.1%) patients had seizure diagnosis at baseline. Seizure prevalence was significantly higher among patients without Alzheimer or Parkinson’s disease (32.4% vs. 18.5%) compared with their respective counterparts. In multivariable Cox models, seizures were independently associated with reduced OS after adjustment for covariates (hazard ratio [HR], 1.22; 95% CI, 1.02-1.46; p = 0.029). In subgroup analyses, seizures remained significantly associated with worse OS among patients with non-Alzheimer’s and non-Parkinson’s disease etiologies, whereas no significant association was observed among patients with Alzheimer’s or Parkinson’s disease.
CONCLUSIONS: Seizures were common among patients with EOD and were independently associated with reduced OS. The adverse prognostic impact of seizures varied by dementia etiology, with significant associations observed in non-Alzheimer’s and non-Parkinson’s disease subgroups. These findings highlight the importance of seizure management and risk stratification in EOD patients.
METHODS: We conducted a retrospective longitudinal cohort study using data from the University of California, San Francisco Clinical Data Warehouse (UCSF CDW) from 2015 to 2025. Adult individuals with a documented diagnosis of dementia who were younger than 65 years during the study period were included in the analytic cohort. Patients were followed from cohort entry until death or the last date of cohort entry (Jun. 30, 2025), with censoring at the time of loss to follow-up. Descriptive analyses were used to estimate the prevalence of seizures. Multivariable Cox proportional hazard models were applied to examine the association between seizures and overall survival (OS).
RESULTS: A total of 2,633 patients with EOD were identified. The cohort was predominately aged 55-64 years (68.8%), male (53%), non-Hispanic White (53%), publicly insured (53.6%), and with a Charlson Comorbidity Index (CCI) of 1 to 2 (63.3%). Overall, 765 (29.1%) patients had seizure diagnosis at baseline. Seizure prevalence was significantly higher among patients without Alzheimer or Parkinson’s disease (32.4% vs. 18.5%) compared with their respective counterparts. In multivariable Cox models, seizures were independently associated with reduced OS after adjustment for covariates (hazard ratio [HR], 1.22; 95% CI, 1.02-1.46; p = 0.029). In subgroup analyses, seizures remained significantly associated with worse OS among patients with non-Alzheimer’s and non-Parkinson’s disease etiologies, whereas no significant association was observed among patients with Alzheimer’s or Parkinson’s disease.
CONCLUSIONS: Seizures were common among patients with EOD and were independently associated with reduced OS. The adverse prognostic impact of seizures varied by dementia etiology, with significant associations observed in non-Alzheimer’s and non-Parkinson’s disease subgroups. These findings highlight the importance of seizure management and risk stratification in EOD patients.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P31
Topic
Clinical Outcomes
Topic Subcategory
Relating Intermediate to Long-term Outcomes
Disease
SDC: Neurological Disorders, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)