Disability in people with epilepsy: A nationally representative cross-sectional study

癫痫 医学 横断面研究 精神科 共病 全国健康与营养检查调查 入射(几何) 置信区间 儿科 物理疗法 人口 内科学 环境卫生 光学 物理 病理
作者
Samuel W. Terman,Chloé E. Hill,James Burke
出处
期刊:Epilepsy & Behavior [Elsevier BV]
卷期号:112: 107429-107429 被引量:26
标识
DOI:10.1016/j.yebeh.2020.107429
摘要

Objective The objective of this study was to explore the prevalence and predictors of limitations causing disability in patients treated for seizures or epilepsy compared with patients without epilepsy. Methods This was a retrospective cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). We included all participants ≥20 years old for 2013–2018. We classified patients as having epilepsy if they reported taking at least one prescription medication to treat seizures or epilepsy. Physical, mental, and social limitations were determined from interview questions. We report the prevalence of any limitation and total number of limitations for participants without vs. with epilepsy using serial negative binomial regressions and severity of individual limitations according to epilepsy status. Results We included 17,057 participants, of whom 148 (0.8%) had epilepsy. Overall, 80% (95% confidence interval [CI]: 73%–86%) with epilepsy vs. 38% (95% CI: 36%–39%) without epilepsy reported at least 1 limitation (p < 0.01). The mean number of limitations was 7.5 (95% CI: 6.2–8.8) for those with epilepsy vs. 2.4 (95% CI: 2.3–2.6) for those without epilepsy (p < 0.01). Epilepsy was associated with an incidence rate ratio (IRR) of 3.1 (95% CI: 2.6–3.7) in an unadjusted negative binomial regression. After adjusting for demographics and comorbidities, this association was no longer significant (IRR: 1.2, 95% CI: 0.9–1.7). Limitations cited by 40–50% of participants with epilepsy included stooping/kneeling/crouching, standing for long periods of time, and pushing/pulling objects. Limitation severity was consistently higher in patients with epilepsy. Conclusions Patients with epilepsy had 3.1 times as many physical, mental, or social limitations compared with those without epilepsy, and disability severity was consistently higher. This effect was attenuated after considering baseline variables such as smoking and depression severity. Our work implies the importance of structured mental health screening and self-management programs targeting mood, weight, and lifestyle as potential leverage points towards alleviating epilepsy-related disability.
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