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A recent study from Austria estimated an incidence of 89.6\/100\u2009000 and 67.6\/100\u2009000 person\u2010years adjusted for age and sex in women and men aged &gt;60\u2009years, respectively, compared to 18.1\/100\u2009000 in adults aged &lt;60\u2009years. In\u2010hospital mortality associated with SE increases fourfold from the 3rd to 9th decade of life. There are multiple important considerations unique to older adults. Etiologies, including ischemia, hemorrhage, and neoplasm, are more common in older adults and are independently associated with poorer outcomes. Important physiological changes of aging affect both the pharmacokinetics and pharmacodynamics of established treatments for SE. Pharmacology studies have shown differences in sensitivity to benzodiazepines and benzodiazepine elimination, as well as greater unpredictability of antiseizure medications such as phenytoin. Older adults have been largely underrepresented in high\u2010quality randomized clinical trials of SE treatment relative to the incidence of SE in this population. The Established Status Epilepticus Treatment Trial published a post hoc analysis of older adults that showed similar efficacy of treatments, although many older trials did not stratify by age, limiting the opportunity to recognize age\u2010related differences in efficacy and safety. Future research should be aimed at investigating treatment selection and dosing in older adults with SE.<\/jats:p>","DOI":"10.1111\/epi.18453","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T07:29:18Z","timestamp":1747207758000},"page":"3118-3137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Status epilepticus in older adults: A critical review"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-4356","authenticated-orcid":false,"given":"Matthew R.","family":"Woodward","sequence":"first","affiliation":[{"name":"Department of Neurology, Program in Trauma, Shock Trauma Center University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Armahizer","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore 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