A recent study published in the journal JAMA Neurology has identified a significant link between cardiovascular health and the risk of developing epilepsy in older adults. Researchers found that conditions such as high blood pressure and diabetes, both common and closely related to lifestyle factors like obesity, poor diet, and physical inactivity, substantially increase the likelihood of epilepsy onset in this population.
The study also highlighted smoking and a history of stroke as additional factors elevating epilepsy risk. Individuals who have previously experienced a stroke were found to be nearly twice as likely to develop epilepsy, a relationship experts attribute to damage in the brain's blood vessels. This vascular injury can disrupt the normal electrical activity within brain cells, thereby increasing seizure susceptibility.
However, cardiovascular disease is not the sole contributor to epilepsy risk in older adults. According to neurologist Dr. Chan, the natural aging process itself may elevate susceptibility. He points to neurodegeneration—progressive damage and loss of brain cells associated with disorders such as Alzheimer’s disease—as a possible factor. The growing number of people living into their seventies and eighties also means more individuals are being diagnosed with epilepsy later in life, even though the overall rate of new cases remains relatively stable.
The real-world impact of this connection is illustrated by cases like Hilary Pegg, a former teacher diagnosed with epilepsy at age 66 following a stroke. Now 75, Pegg experiences annual seizures and relies on anti-seizure medication, with no reliable way to predict when an attack will occur. She notes the strain epilepsy has placed on her daily life, including concerns from family members about her safety.
Experts emphasize that while there is no universal method to prevent epilepsy, many heart-healthy habits may also protect brain health. These include maintaining a balanced diet, engaging in regular physical activity, and prioritizing restful sleep. Dr. Chan stresses the often-overlooked role of sleep, stating that good sleep hygiene is crucial for brain function and seizure control.
Despite increasing recognition of epilepsy's prevalence among older adults, underdiagnosis remains a challenge. Dr. Chan notes that general practitioners may lack adequate training to identify subtler seizure types, which do not always involve dramatic convulsions. Diagnosis often depends heavily on neurologist expertise and diagnostic tools such as EEGs.
Additionally, hormonal factors can influence seizure patterns, particularly in women. Professor Marson explains that seizures commonly cluster around menstrual periods due to fluctuating estrogen levels, a factor that can complicate diagnosis and management. One patient, Claire, experienced seizure-like episodes initially mistaken for menopausal hot flashes until adjustments to hormone replacement therapy improved her symptoms. Since starting anti-seizure medication, she has been seizure-free and employs strategies to manage memory difficulties associated with her condition.
Epilepsy affects roughly one in 100 people in the United Kingdom and is characterized by recurrent seizures caused by abnormal electrical activity in the brain. Seizures can vary widely in presentation, from brief lapses in awareness to sudden muscle jerks or loss of muscle tone. While there is no cure, anti-seizure medications are effective for most patients; alternative treatments include surgery or vagus nerve stimulation for cases that are resistant to medication.
Medical experts advise seeking emergency care if a seizure lasts longer than five minutes, if it is a person’s first seizure, or if multiple seizures occur without recovery between episodes.