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Epilepsy and early dementia are more connected than we thought. A large multinational study found that people with epilepsy face roughly six times the risk of developing dementia before age 65 compared to those without it — though the absolute risk remains low. Experts say managing cardiovascular risk factors and earlier cognitive screening could make a real difference for this population.
Epilepsy and young-onset dementia (YOD) — dementia diagnosed before age 65 — are more intertwined than previously recognized. A new study published in Neurology analyzed three large nationwide datasets from France and Sweden, finding that epilepsy is strongly and consistently associated with an elevated risk of early dementia across multiple study designs.
In the French case-control analysis, over 12% of YOD patients had a prior epilepsy diagnosis, compared to just 1.2% of controls. People with newly diagnosed epilepsy had about six times the 10-year risk of developing YOD compared to those without epilepsy. Notably, those with four or more comorbidities saw incidence climb to 9.1%, with cardiovascular conditions being especially common.
Researchers caution that causality hasn't been established — it's unclear whether epilepsy drives dementia, or whether both stem from shared underlying factors. Still, the findings carry clear clinical implications.
Key Takeaways:
Why it matters: These findings make a strong case for weaving dementia prevention into routine epilepsy care — especially for patients with cardiovascular risk factors. Earlier cognitive screening and aggressive management of modifiable risks like high blood pressure could help protect long-term brain health in this vulnerable group.
