Prevalence and Incidence of Epilepsy in an Elderly and Low-Income Population in the United States
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Background and Purpose Te purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. Methods Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged ≥65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for ≥12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year “clean” period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. Results Te estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. Te incidence and prevalence rates were signifcantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). Te prevalence rates were signifcantly higher for non-Hispanic Blacks and male benefciaries than for non-Hispanic Whites and female benefciaries, respectively (p<0.05). Conclusions Tis patient population had higher epilepsy incidence and prevalence compared with the general US population. Tese diferences may be at least in part attributable to their low socioeconomic status.
Abstract
Background and Purpose Te purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. Methods Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged ≥65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for ≥12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year “clean” period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. Results Te estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. Te incidence and prevalence rates were signifcantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). Te prevalence rates were signifcantly higher for non-Hispanic Blacks and male benefciaries than for non-Hispanic Whites and female benefciaries, respectively (p<0.05). Conclusions Tis patient population had higher epilepsy incidence and prevalence compared with the general US population. Tese diferences may be at least in part attributable to their low socioeconomic status.
참고문헌 (36)
- Guidelines for epidemiologic studies on epilepsy, "Commission on epidemiology and prognosis, international league against epilepsy", Epilepsia, 34, pp.592~596 (1993)
- Werhahn KJ, "Epilepsy in the elderly", Dtsch Arztebl Int, 106, pp.135~142 (2009)
- Kelvin EA, "Prevalence of self-reported epilepsy in a multiracial and multiethnic community in New York City", Epilepsy Res, 77, pp.141~150 (2007)
- Koul R, "Prevalence and pattern of epilepsy (Lath", Mirgi, Epilepsia, pp.1988, 29[DOI]
- Lavados J, "A descriptive study of epilepsy in the district of El Salvador, Chile, 1984-1988", Acta Neurol Scand, 85, pp.249~256 (1992)
- 이서영, "Prevalence of Treated Epilepsy in Korea Based on National Health Insurance Data", Journal of Korean Medical Science, 27(3), pp.285~290 (2012), 대한의학회
- Melcon MO, "Prevalence and clinical features of epilepsy in Argentina. A community-based study", roepidemiology, 28, pp.8~15 (2007)
- Picot MC, "The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country", Epilepsia, 49, pp.1230~1238 (2008)
- Winkler AS, "Prevalence, incidence, and clinical characteristics of epilepsy--a community-based door-to-door study in northern Tanzania", Epilepsia, 50, pp.2310~2313 (2009)
- Banerjee PN, "The descriptive epidemiology of epilepsy-a review", Epilepsy Res, 85, pp.31~45 (2009)
- Benn EK, "Estimating the incidence of first unprovoked seizure and newly diagnosed epilepsy in the low-income urban community of Northern Manhattan", Epilepsia, 49, pp.1431~1439 (2008)
- Hauser WA, "Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984", Epilepsia, 34, pp.453~468 (1993)
- Cloyd J, "Epidemiological and medical aspects of epilepsy in the elderly", Epilepsy Res, 68(1), pp.S39~S48 (2006)
- Beghi E, "Handbook of Clinical Neuroepidemiology", pp.123~165 (2007), Nova Science Publisher
- Sillanpää M, "Regional differences and secular trends in the incidence of epilepsy in Finland: a nationwide 23-year registry study", Epilepsia, 52, pp.1857~1867 (2011)
- Hesdorffer DC, "Dementia and adult-onset unprovoked seizures", Neurology, 46, pp.727~730 (1996)
- Noronha AL, "Prevalence and pattern of epilepsy treatment in different socioeconomic classes in Brazil", Epilepsia, 48, pp.880~885 (2007)
- Birbeck G, "The social and economic impact of epilepsy in Zambia: a cross-sectional study", Lancet Neurol, 6, pp.39~44 (2007)
- Hesdorffer DC, "Socioeconomic status is a risk factor for epilepsy in Icelandic adults but not in children", Epilepsia, 46, pp.1297~1303 (2005)
- Li X, "Socioeconomic and occupational risk factors for epilepsy: a nationwide epidemiological study in Sweden", Seizure, 17, pp.254~260 (2008)
- "Arizona Health Care Cost Containment System" (2012)[URL]
- "United States Census Bureau" (2013)[URL]
- Ngugi AK, "Incidence of epilepsy: a systematic review and meta-analysis", Neurology, 77, pp.1005~1012 (2011)
- Faught E, "Incidence and prevalence of epilepsy among older U.S. Medicare beneficiaries", Neurology, 78, pp.448~453 (2012)
- Kaiboriboon K, "Incidence and prevalence of treated epilepsy among poor health and low-income Americans", Neurology, 80, pp.1942~1949 (2013)
- "National Quality Measures Clearinghouse" (2012)[URL]
- Kee VR, "A systematic review of validated methods for identifying seizures, convulsions, or epilepsy using administrative and claims data", Pharmacoepidemiol Drug Saf, 21(1), pp.183~193 (2012)
- Arain AM, "Management of new-onset epilepsy in the elderly", Nat Rev Neurol, 5, pp.363~371 (2009)
- Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation", J Chronic Dis, 40, pp.373~383 (1987)
- Quan H, "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data", Med Care, 43, pp.1130~1139 (2005)
- Hosmer DW, "Applied logistic regression" (2000), John Wiley & Sons
- Harrell FE, "Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis" (2001), Springer
- Holden EW, "Developing a computer algorithm to identify epilepsy cases in managed care organizations", Dis Manag, 8, pp.1~14 (2005)
- Holden EW, "Estimating prevalence, incidence, and disease-related mortality for patients with epilepsy in managed care organizations", Epilepsia, 46, pp.311~319 (2005)
- Mani KS, "The Yelandur study: a community-based approach to epilepsy in rural South India--epidemiological aspects", Seizure, 7, pp.281~288 (1998)
- Johnston SC, "Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling", Lancet Neurol, 8, pp.345~354 (2009)