Epileptic Patients with More Clinic Visits Are More Likely to Be Diagnosed with Dementia—A Population-Based Retrospective Cohort Study

Abstract

Objective: This retrospective cohort study assessed dementia risk in epilepsy patients associated with the compliance to epileptic treatment visits. Methods: We used Taiwanese insurance claims data to establish an epilepsy cohort (N = 39,216) diagnosed in 2000–2015 and a matched control cohort without epilepsy (N = 156,864), evaluating the incident dementia by the end of 2016. Results: The dementia incidence was 2.9-fold higher in the epilepsy cohort than in comparisons (4.68 vs. 1.59 per 1000 person-years). Only 9.3% of epilepsy patients were compliant to ≥80% of scheduled treatment visits, but they exhibited a 7.2-fold higher dementia incidence than those without treatment. The contrast was greater in younger patients than in the elderly (20-fold versus 5.5-fold). Dementia incidence increased with the frequency of neurological consultations, peaking in the first year after epilepsy diagnosis. Conclusions: Epileptic patients with more clinical visits for active treatment had a higher chance of dementia diagnosis, highlighting the importance of close neurological monitoring post-epilepsy diagnosis to address potential dementia complications.