Master's student Research Centre of the Centre Hospitalier de l’Université de Montréal (crCHUM) Montréal, Quebec, Canada
Rationale: Frailty is an important aspect of biological aging, referring to the increased vulnerability of frail individuals to physical and psychological stressors. Numerous studies have demonstrated that frailty is strongly associated with loss of functional independence and cognitive decline, as well as the occurrence of chronic diseases (e.g., cardiovascular). While older adults with epilepsy are an important and distinct clinical group, there are no data on frailty in this population. We hypothesize that frailty will correlate with the efficacy and especially the tolerability of antiseizure medications (ASMs) in older adults with epilepsy.
Methods: This is a cross-sectional observational study. We are recruiting participants from four Canadian hospital centers, aged 60 years or older with active epilepsy. ASM efficacy will be assessed using seizure frequency, while tolerability will be quantified using the Liverpool Adverse Events Profile (LAEP). We are applying three measures of frailty: grip strength as a measure of physical frailty, one self-reported score [Edmonton Frailty Score (EFS)], and one scale completed by a health-care professional [Clinical Frailty Scale (CFS)]. We are also administering standardized questionnaires measuring levels of anxiety, depression, functional disability, and quality of life. Results: Thirty-one women and 36 men aged 60-93 years have been recruited thus far, 89% of whom have focal epilepsy, with an average frequency of 4.6 seizures per month. Preliminary analyses show a clear correlation between ASM tolerability and two measures of frailty: the EFS [Spearman’s rank correlation coefficient = 0.52 (95% CI: 0.28 – 0.72)] and CFS [correlation coefficient = 0.31 (95% CI: 0.05 – 0.53)].
Conclusions: Our preliminary analyses show clear correlations between frailty and ASM tolerability. Frailty may become an important means of tailoring ASM choice in older adults with epilepsy, allowing clinicians to predict ASM efficacy and especially tolerability. We expect to complete recruitment for our study by autumn 2020. Funding: Please list any funding that was received in support of this abstract.: Canadian Frailty Network