Authors: Heidi Taipale, Willy Gomm, Karl Broich, Wolfgang Maier, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Britta Haenisch
Summary: Objectives: To evaluate the association between regular antiepileptic drug (AED) use and incident dementia.
Design: Case‐control analysis.
Setting: Finnish public health register and German health insurance data.
Participants: Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Finnish data, N=70,718) were matched with up to four control persons without dementia.
Measurements: We analyzed the association between regular AED use and dementia. To address potential protopathic bias, a lag time of 2 years between AED use and dementia diagnosis was introduced. Odds ratios (ORs) were calculated by applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy.
Results: Regular AED use was more frequent in individuals with dementia than controls. Regular use of AEDs was associated with a significantly greater risk of incident dementia (adjusted OR=1.28, 95% confidence interval (CI)=1.14–1.44) and AD (adjusted OR=1.15, 95% CI=1.09–1.22) than no AED use. We also detected a trend toward greater risk of dementia with higher exposure. When AEDs with and without known cognitive adverse effects (CAEs) were compared, a significantly greater risk of dementia was observed for substances with known CAEs (dementia: OR=1.59, 95% CI=1.36–1.86; AD: OR=1.19, 95% CI=1.11–1.27).
Conclusion: AEDs, especially those with known CAEs, may contribute to incident dementia and AD in older persons.
Source: Journal of the American Geriatrics Society, 2018