Study Maps US Regions with High Epilepsy Rates Among Seniors

A groundbreaking study has identified key regions in the United States where the incidence of epilepsy is notably high among older adults. Published in JAMA Neurology, this research highlights the prevalence of epilepsy within specific areas, particularly in the southern states. Conducted by researchers from the Houston Methodist Research Institute and Case Western Reserve University, the analysis sheds light on the social and environmental factors influencing this neurological condition.

The study found that adults aged 65 and older exhibit significantly higher rates of epilepsy in states such as Louisiana, Mississippi, East Texas, and central Oklahoma. According to the U.S. Centers for Disease Control and Prevention, an estimated 3.3 million people in the United States live with epilepsy. In 2019, healthcare expenditures related to epilepsy and seizures reached $24.5 billion, underscoring the condition’s considerable impact on public health.

Weichuan Dong, Ph.D., the lead investigator and assistant professor at the Houston Methodist DeBakey Heart & Vascular Center, emphasized the significance of this research for understanding the burden of epilepsy among older adults. “Until now, we didn’t have a national picture of where epilepsy affects older adults the most,” Dong stated. The application of advanced geospatial mapping to Medicare data allowed the researchers to uncover distinct clusters of high epilepsy rates, coining the term “epilepsy belt” for these regions. Dong added, “Understanding where the burden lies is the first step toward uncovering why and helping communities reduce risk.”

The study also identified several factors associated with increased epilepsy incidence. These included insufficient sleep (defined as less than seven hours per night), exposure to extreme heat (more days with a heat index above 95 degrees), limited physical activity, lack of health insurance among younger adults—which suggests delays in diagnosis until Medicare eligibility—and inadequate access to a household vehicle. These conditions, often influenced by local environments and socioeconomic status, were found to be more prevalent in areas with the highest rates of epilepsy.

Siran Koroukian, Ph.D., a professor at Case Western Reserve University, commented on the implications of the findings, stating, “This is the first study documenting such a strong association between extreme heat and incident epilepsy in older adults across the U.S., highlighting the importance of climate change in emergency preparedness, especially given the graying of the population.”

Researchers utilized advanced geospatial machine learning algorithms to analyze data from 4.8 million Medicare beneficiaries between 2016 and 2019. The study relied on data from the U.S. Medicare Master Beneficiary Summary File and the Agency for Healthcare Research and Quality. It is important to note that Alaska and Hawaii were excluded from the analysis due to incomplete data regarding social and environmental determinants of health.

This research reveals previously hidden patterns in national data, illustrating how factors such as neighborhood sleep habits, heat exposure, healthcare access, and vehicle availability can influence health outcomes. Additional predictors of higher epilepsy rates included the prevalence of obesity and the availability of primary care physicians.

In light of these findings, the study encourages further exploration into the geographical and environmental elements that contribute to epilepsy among older adults. As communities strive to improve health outcomes, understanding the specific challenges faced in high-incidence areas will be crucial for developing targeted prevention and care strategies.

More information on this study can be found in the article titled “Incidence and Risk Factors of Epilepsy Among Older Adults in the US Medicare Population” by Weichuan Dong et al, published in JAMA Neurology.