{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:17:51Z","timestamp":1790011071479,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:00:00Z","timestamp":1603411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the clinical characteristics and evaluate the long\u2010term treatment outcomes in older people with newly diagnosed epilepsy over the past 30\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included patients newly diagnosed with epilepsy and commenced on antiseizure medications (ASMs) at age 65\u00a0years or older between July 1982 and October 2012 at the Western infirmary in Glasgow, Scotland. They were followed up until April 2016 or death. Seizure freedom was defined as no seizure for at least 1\u00a0year on unchanged medication at the last follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 201 patients (median age 73\u00a0years, 59% male) were included. The median duration from initial seizure to starting treatment was 8 months (interquartile range: 3.0\u201024.0 months); 42.2% (85\/201) patients had more than five seizures before commencing treatment. Brain imaging showed potentially epileptogenic lesions in 19.7% (38\/193) of patients and other abnormalities in 56.5% (109\/193); 78.6% patients (158\/201) were seizure\u2010free at the last follow\u2010up, of whom 94.9% were taking monotherapy. Concomitant aspirin use (n\u00a0=\u00a080) was associated with a lower probability of being seizure\u2010free (relative risk 0.82, 95% confidence interval 0.70\u20100.97; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). The use of second\u2010generation ASMs as the initial monotherapy increased from 31.5% (23\/73) before 2000 to 70.3% (90\/128, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) from 2000 onward. However, the seizure freedom rates (67.1% vs 55.5%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.35) and intolerable adverse\u2010effect rates (16.4% vs 19.5%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.45) did not show any significant difference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>There was often a long interval between seizure onset and the initiation of treatment in older people with new\u2010onset epilepsy, although the majority responded well to ASM treatment. Brain imaging showed a high rate of abnormalities. Despite the increased use of second\u2010generation ASMs, treatment outcomes in later\u2010onset epilepsy have not improved over time. The possible effect of aspirin on treatment response warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16721","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T03:14:32Z","timestamp":1603509272000},"page":"2720-2728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Characteristics and treatment outcomes of newly diagnosed epilepsy in older people: A 30\u2010year longitudinal cohort study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6489-6035","authenticated-orcid":false,"given":"Bshra Ali A.","family":"Alsfouk","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences College of Pharmacy Princess Nourah Bint Abdulrahman University Riyadh Saudi Arabia"},{"name":"University of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7902-2362","authenticated-orcid":false,"given":"Haris","family":"Hakeem","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Central Clinical School Monash University Alfred Hospital Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1888-6917","authenticated-orcid":false,"given":"Zhibin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Central Clinical School Monash University Alfred Hospital Melbourne Vic. Australia"},{"name":"Department of Medicine \u2013 Royal Melbourne Hospital The University of Melbourne Melbourne Vic. Australia"},{"name":"Clinical Epidemiology School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Walters","sequence":"additional","affiliation":[{"name":"University of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1781-2892","authenticated-orcid":false,"given":"Martin J.","family":"Brodie","sequence":"additional","affiliation":[{"name":"University of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-276X","authenticated-orcid":false,"given":"Patrick","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Central Clinical School Monash University Alfred Hospital Melbourne Vic. Australia"},{"name":"Department of Medicine \u2013 Royal Melbourne Hospital The University of Melbourne Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2009.03.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare3041271"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2017.05.002"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2005.11.007"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13653"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.14581\/jer.19003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2013.06.005"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30035-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3949"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.0032"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420503"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.8_suppl_5.S2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70240-6"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12550"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13671"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13127"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.62.5_suppl_2.S24"},{"issue":"2","key":"e_1_2_7_20_1","first-page":"63","article-title":"Epilepsy in the elderly","volume":"6","author":"Chen LA","year":"2012","journal-title":"J Gerontol"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528-1157.43.s.3.10.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00995"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12720"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a35193"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcis.JCIS_38_18"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.4.466"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-2327.104335"},{"issue":"2","key":"e_1_2_7_28_1","first-page":"47","article-title":"New onset seizures in the elderly: aetiology and prognosis","volume":"95","author":"Timmons S","year":"2002","journal-title":"Ir Med J"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2016.03.011"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)63125-X"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2003.14"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2018.08.162"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.163"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1004418"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03671.x"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000167384.68207.3E"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-1211(99)00039-X"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12926"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2007.01128.x"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.49"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2009.10.011"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16721","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/epi.16721","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T01:57:54Z","timestamp":1693879074000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.16721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,23]]},"references-count":40,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/epi.16721"],"URL":"https:\/\/doi.org\/10.1111\/epi.16721","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,23]]},"assertion":[{"value":"2020-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}