title: Correlates of disability related to seizures in persons with epilepsy.
abstract: OBJECTIVE
  Seizure-related disability is an important contributor to health-related quality of life in persons with epilepsy. Yet, there is little information on patient-centered reports of seizure-related disability, as most studies focus on specific constructs of health-related disability, rather than epilepsy. We investigated how patients rate their own disability and how these ratings correlate with various clinical and sociodemographic characteristics.
  
  
  METHODS
  In a prospective cohort of 250 adults with epilepsy consecutively enrolled in the Neurological Disease and Depression Study (NEEDs), we obtained a broad range of clinical and patient-reported measures, including patients' ratings of seizure-related disability and epilepsy severity using self-completed, single-item, 7-point response global assessment scales. Spearman's correlation, multiple linear regression, and mediation analyses were used to examine the association between seizure-related disability scores and clinical and demographic characteristics of persons with epilepsy.
  
  
  RESULTS
  The mean age and duration of epilepsy was 39.8 and 16.7 years, respectively. About 29.5% of the patients reported their seizures as "not at all disabling," whereas 5.8% of the patients reported them as "extremely disabling." Age, seizure freedom at 1 year, anxiety, and epilepsy severity were identified as statistically significant predictors of disability scores. The indirect effects of age and seizure freedom, attributable to mediation through epilepsy severity, accounted for 25.0% and 30.3% of the total effects of these determinants on seizure-related disability, respectively.
  
  
  CONCLUSIONS
  Measuring seizure-related disability has heuristic value and it has important correlates and mediators that can be targeted for intervention in practice. Addressing modifiable factors associated with disability (e.g., seizure freedom and anxiety) could have a significant impact on decreasing the burden of disability in people with epilepsy.
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Clinical Research Unit, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Tolulope T
authors.initials: TT
authors.lastname: Sajobi
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jette
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Fiest
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: Clinical Research Unit, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jordan D T
authors.initials: JD
authors.lastname: Engbers
authors.affiliation: Clinical Research Unit, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Lowerison
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Clinical Research Unit, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001526:Behavioral Symptoms / Q000209:etiology*; D015331:Cohort Studies; D006233:Persons with Disabilities; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000209:etiology*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Depression; Disability; Epilepsy; Mediation analysis; Seizures