title: Health-related quality of life in senior adults with epilepsy: what we know from randomized clinical trials and suggestions for future research.
abstract: OBJECTIVE
  The goal of this work was to review the randomized controlled trial (RCT) literature on antiepileptic medication effects on health-related quality of life in seniors with epilepsy.
  
  
  METHODS
  Studies published from 1998 to June 2002 were identified by searching through Medline and the Cochrane Clinical Trials Register. Pre-1998 RCTs identified by Baker et al. [Epilepsia 41 (2003) 1357] were also examined for relevance to the present review. Studies were reviewed if they included a RCT design and included epilepsy patients over the age of 60.
  
  
  RESULTS
  A total of 85 clinical trials were reviewed. Of the 85 studies reviewed only 37 RCT studies included patients over the age of 60. However, formal quality-of-life outcome assessment was not performed in any of the RCTs that included senior adults, and only six studies provided formal quantitative analyses of AED effects in the form of adverse events incidence and participant withdrawal rates. For the most part, early study withdrawal rates were substantial for seniors and adverse events were very common. Two studies reporting on the cognitive and behavioral effects of study AEDs indicated only modest impact when AED monotherapy was kept at therapeutic levels.
  
  
  CONCLUSIONS
  Despite growing appreciation for quality-of-life, issues in the management of epilepsy little current empirical guidance is available for elderly with epilepsy. There exists virtually no information on elderly patient preferences and goals for epilepsy treatment outcomes, and available data primarily concerns younger adults. Despite some encouraging preliminary evidence from this review suggesting that conservative AED treatment may have a more favorable quality of life-related outcome, more conclusive statements await further systematic investigation.
authors.affiliation: Department of Neurology, UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA. martin@uab.edu
authors.forename: Roy
authors.initials: R
authors.lastname: Martin
authors.forename: Laura
authors.initials: L
authors.lastname: Vogtle
authors.forename: Frank
authors.initials: F
authors.lastname: Gilliam
authors.forename: Edward
authors.initials: E
authors.lastname: Faught
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005544:Forecasting; D006299:Health Services for the Aged; D006801:Humans; D016239:MEDLINE; D008875:Middle Aged; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design; D016896:Treatment Outcome