ArticleEpilepsy & behavior : E&B2024
Individual- and community-level social determinants of health are associated with cognition in older adults with focal epilepsy.
Article in Epilepsy & behavior : E&B, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Effect Modification of Alcohol Use on Epilepsy: NHIS Longitudinal Study.Biomedicines · 2026Article
- Advancing Mental Health Equity in Epilepsy: Social Determinants of Health Across the Lifespan.Epilepsy currents · 2026Review
- The role of social context in cognitive and neurobehavioural outcomes in epilepsy.Nature reviews. Neurology · 2026Review
- Neighborhood environmental deprivation predicts the generalized neurocognitive deficit in schizophrenia.Schizophrenia research · 2026Article
- Disentangling deprivation: Differential associations of the area deprivation index- 3 factors with clinical, cognitive, and mood outcomes in epilepsy.Epilepsy & behavior : E&B · 2026Article
- General mental ability (Spearman's g) in Juvenile Myoclonic Epilepsy.Epilepsia open · 2025Article
- Cognitive and brain health in juvenile myoclonic epilepsy: Role of social determinants of health.Epilepsia · 2025Article
- Social determinants of health and rehabilitation service areas: an urban and rural mediation analysis.Frontiers in public health · 2025Observational
- Long-term characterization of behavior phenotypes in children with seizures: Analytic approach matters.Epilepsia · 2025Article
- A user's guide for the International Classification of Cognitive Disorders in Epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2024Review
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11 authors.
Funding
Abstract
objectiveEpilepsy is associated with significant health disparities, including access to specialized care and adverse outcomes that have been associated with several social determinants of health (SDOH). We sought to examine the relationship between individual- and community-level SDOH and cognitive outcomes in older adults with epilepsy. MATERIALS AND
methodsWe collected clinical, SDOH, and neuropsychological data in 57 older adults with epilepsy. Individual-level SDOH included patient factors (quality of education, income, insurance, marital status) and early-life environmental factors (parental education and occupation, childhood employment). Neighborhood deprivation was measured with the Area Deprivation Index (ADI). Stepwise regressions were conducted to examine the independent contribution of individual-level SDOH to cognitive performance, and Spearman rho correlations were conducted to examine the relationship between ADI and cognitive performance. The SDOH profiles of patients who met the criteria for cognitive impairment were examined.
resultsAfter controlling for clinical variables, patient factors (public health insurance, poorer quality of education) and early-life environmental factors (lower mother's education, lower father's and mother's occupational complexity, history of childhood employment) were significant predictors of lower performance on measures of global cognition, verbal learning and memory, processing speed, and executive function. Higher ADI values (greater disadvantage) were associated with lower scores on global cognitive measures, verbal learning and memory, and executive function. Patients who met criteria for cognitive impairment had, on average, a greater number of adverse SDOH, including lower household incomes and father's education, and higher ADI values compared to those who were cognitively intact.
conclusionWe provide new evidence of the role of individual- and community-level SDOH on cognitive outcomes in older adults with epilepsy. This emerging literature highlights the need to examine SDOH beyond epilepsy-related clinical factors. These data could inform the development of interventions focused on increasing access to epilepsy care, education, and resources and promoting brain and cognitive health within the most at-risk communities.
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