title: Cardiovascular fitness and later risk of epilepsy: a Swedish population-based cohort study.
abstract: OBJECTIVE
  To analyze the associations between cardiovascular fitness at age 18 years and future risk of epilepsy.
  
  
  METHODS
  Population-based cohort study of Swedish male conscripts (n = 1,173,079) born in 1950-1987, who were followed for up to 40 years. Data on cardiovascular fitness were collected during conscription exams and linked with hospital registers to calculate later risk of epilepsy using Cox proportional hazard models controlling for several confounders, including familial factors.
  
  
  RESULTS
  Epilepsy was recorded in 6,796 individuals during the follow-up time. In fully adjusted models, low and medium cardiovascular fitness (compared with high) at age 18 years was associated with increased risk of future epilepsy (hazard ratio 1.79, 95% confidence interval 1.57-2.03; and hazard ratio 1.36, 95% confidence interval 1.27-1.45, respectively). The associations changed only marginally after adjustment for familial influences and prior severe traumatic brain injury, cerebrovascular disease, or diabetes.
  
  
  CONCLUSIONS
  Low cardiovascular fitness early in life is associated with an increased risk of epilepsy later in adulthood. These results agree with previous results from animal models. We propose that behaviors that increase cardiovascular fitness may act as positive disease-modifiers for the development of epilepsy.
authors.affiliation: From the Center for Brain Repair and Rehabilitation (J.N., M.A.I.Å., M.N., E.B.-M., H.G.K.), Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; Occupational and Environmental Medicine (K.T.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; and Hunter Medical Research Institute (M.N.), University of Newcastle, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Nyberg
authors.forename: Maria A I
authors.initials: MA
authors.lastname: Aberg
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
authors.forename: Michael
authors.initials: M
authors.lastname: Nilsson
authors.forename: Elinor
authors.initials: E
authors.lastname: Ben-Menachem
authors.forename: H Georg
authors.initials: HG
authors.lastname: Kuhn
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000150:complications* / Q000503:physiopathology; D015331:Cohort Studies; D004827:Epilepsy / Q000453:epidemiology / Q000209:etiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010809:Physical Fitness / Q000502:physiology*; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology