{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:04Z","timestamp":1790675884479,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23NS119798"],"award-info":[{"award-number":["K23NS119798"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001454","name":"American Epilepsy Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001454","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Late onset unexplained epilepsy (LOUE) is linked to cognitive and functional decline, yet determinants of functional impairment are not well defined. We evaluated the Functional Activities Questionnaire (FAQ) in LOUE and examined its association with cognitive and epilepsy\u2010related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included adults with unexplained seizure onset after age 55\u2009years, nonlesional magnetic resonance imaging, seizure onset within 5\u2009years, and stable antiseizure medication (ASM) use. Study partners completed the FAQ; scores \u2265\u20096 indicated functional impairment. A delayed verbal recall composite was calculated and standardized using Harvard Aging Brain Study norms. Firth penalized logistic regression identified predictors of functional impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 82 participants, 12.2% were functionally impaired. Demographic characteristics were similar between groups. Impaired participants showed significantly worse cognitive performance, greater ASM use, higher rates of drug\u2010resistant epilepsy, longer epilepsy duration, and more frequent focal impaired consciousness and generalized tonic\u2013clonic seizures, with memory\u2010related tasks most affected. A higher ASM number (odds ratio [OR] =\u20092.74, 95% confidence interval [CI] =\u20091.31\u20136.74) and a lower delayed verbal recall\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score (OR = .37, 95% CI = .14\u2013.69) were associated with increased odds of functional impairment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Functional impairment in LOUE is associated with poorer cognition and greater ASM burden. The FAQ may serve as a practical screening tool to assess functional impairment. Our study emphasizes the importance of minimizing medication burden in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70357","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:28:34Z","timestamp":1782476914000},"page":"4968-4977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the relationship between everyday functioning and cognitive performance in individuals with late onset unexplained epilepsy"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4433-8475","authenticated-orcid":false,"given":"Nour","family":"Abi Chakra","sequence":"first","affiliation":[{"name":"Neurology Department Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Hankerson","sequence":"additional","affiliation":[{"name":"Neurology Department Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad A.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Neurology Department Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-7864","authenticated-orcid":false,"given":"Rani A.","family":"Sarkis","sequence":"additional","affiliation":[{"name":"Neurology Department Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.851897"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16616"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.81a.13148"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.41223"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2016.01.011"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191121991215"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.03.069"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11055\u2010012\u20109665\u20100"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2015.07.027"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.8_suppl_5.S21"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hipo.20565"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.1.162"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010021\u201005365\u20101"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e3181e2fc84"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010200808"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S104161021600017X"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70099"},{"issue":"4","key":"e_1_2_13_20_1","first-page":"241","article-title":"Incidence of dementia in a community\u2010dwelling Brazilian population","volume":"18","author":"Nitrini R","year":"2004","journal-title":"Alzheimer Dis Assoc Disord"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.2217\/nmt.12.55"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/epd2.20057"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16748"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011080"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.0339"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaf050"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010150096"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000154929"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0014186"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098\u2010014\u20101530\u20104"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1475"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17707"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1684\/j.1950-6945.2004.tb00053.x"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/seiz.2002.0593"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.70062"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0920\u20101211(00)00126\u20101"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/630853"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1101\/lm.024018.111"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/123.3.472"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn127"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2013.00750"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70357","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:17:38Z","timestamp":1790673458000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/epi.70357"],"URL":"https:\/\/doi.org\/10.1002\/epi.70357","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}