Volume 66, Issue 6 p. 1123-1129
Clinical Investigation

Use of Antiepileptic Drugs and Dementia Risk—an Analysis of Finnish Health Register and German Health Insurance Data

Heidi Taipale PhD

Heidi Taipale PhD

School of Pharmacy, University of Eastern Finland, Kuopio, Finland

Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

These authors contributed equally.

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Willy Gomm PhD

Willy Gomm PhD

German Center for Neurodegenerative Diseases, Bonn, Germany

These authors contributed equally.

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Karl Broich MD

Karl Broich MD

Federal Institute for Drugs and Medical Devices, Bonn, Germany

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Wolfgang Maier MD

Wolfgang Maier MD

German Center for Neurodegenerative Diseases, Bonn, Germany

Department of Psychiatry, University of Bonn, Bonn, Germany

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Anna-Maija Tolppanen PhD

Anna-Maija Tolppanen PhD

School of Pharmacy, University of Eastern Finland, Kuopio, Finland

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Antti Tanskanen Phil Lic

Antti Tanskanen Phil Lic

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland

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Jari Tiihonen PhD, MD

Jari Tiihonen PhD, MD

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland

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Sirpa Hartikainen PhD, MD

Sirpa Hartikainen PhD, MD

School of Pharmacy, University of Eastern Finland, Kuopio, Finland

Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland

Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland

These authors contributed equally.

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Britta Haenisch PhD

Corresponding Author

Britta Haenisch PhD

German Center for Neurodegenerative Diseases, Bonn, Germany

These authors contributed equally.

Address correspondence to Britta Haenisch, PhD, German Center for Neurodegenerative Diseases, c/o Federal Institute for Drugs and Medical Devices, Kurt-Georg-Kiesinger-Allee 3, D-53175 Bonn, Germany. E-mail: [email protected].Search for more papers by this author
First published: 22 March 2018
Citations: 38

Abstract

Objectives

To evaluate the association between regular antiepileptic drug (AED) use and incident dementia.

Design

Case-control analysis.

Setting

Finnish public health register and German health insurance data.

Participants

Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Finnish data, N=70,718) were matched with up to four control persons without dementia.

Measurements

We analyzed the association between regular AED use and dementia. To address potential protopathic bias, a lag time of 2 years between AED use and dementia diagnosis was introduced. Odds ratios (ORs) were calculated by applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy.

Results

Regular AED use was more frequent in individuals with dementia than controls. Regular use of AEDs was associated with a significantly greater risk of incident dementia (adjusted OR=1.28, 95% confidence interval (CI)=1.14–1.44) and AD (adjusted OR=1.15, 95% CI=1.09–1.22) than no AED use. We also detected a trend toward greater risk of dementia with higher exposure. When AEDs with and without known cognitive adverse effects (CAEs) were compared, a significantly greater risk of dementia was observed for substances with known CAEs (dementia: OR=1.59, 95% CI=1.36–1.86; AD: OR=1.19, 95% CI=1.11–1.27).

Conclusion

AEDs, especially those with known CAEs, may contribute to incident dementia and AD in older persons.