The impact of epilepsy on health status among younger and older adults.
OBJECTIVE
The incidence of epilepsy is highest among the elderly, yet our understanding of the impact of epilepsy is based predominantly on inferences from studies of younger adults. This study examines the impact of epilepsy on patients' subjective health status in a population that includes both younger and older adults.


METHODS
We used national administrative and survey databases from the Veterans Health Administration to examine health status as measured by a modification of the SF-36 (RV-36) in patients from three age cohorts: young adults (18-40 years), middle-aged adults (41-64 years), and older adults (65 years and older). Because chronicity of epilepsy may influence these outcomes, we compared scores for patients with new-onset epilepsy, chronic epilepsy, and no epilepsy by using analysis of covariance, controlling for patient demographic and clinical characteristics that may also affect health status.


RESULTS
With the exception of physical status measures, older adults appeared to cope better with their epilepsy than did middle-aged patients. Young adults with new-onset epilepsy reported poor general health and worse mental health, but high levels of physical function and physical activity. Middle-aged patients with new-onset epilepsy scored lowest in all domains, and their peers with chronic epilepsy also reported poor general physical health and emotional functioning.


CONCLUSIONS
Although having fewer physiologic reserves, older adults appeared most resilient in facing this chronic illness, and middle-aged adults fared the worst. Interventions to improve quality of life among patients with epilepsy should be tailored to age and epilepsy chronicity.
Pugh
Mary Jo V
MJ
Veterans Affairs HSR&D, South Texas Veterans Health Care System (VERDICT), San Antonio, Texas 78229-4404, USA. PughM@uthscsa.edu
Copeland
Laurel A
LA
Zeber
John E
JE
Cramer
Joyce A
JA
Amuan
Megan E
ME
Cavazos
Jose E
JE
Kazis
Lewis E
LE
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000375:Aging / Q000523:psychology; D001294:Attitude to Health; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012494:Sampling Studies; D018434:Sickness Impact Profile; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data