Global, regional, and national burdens of late-onset epilepsy in adults aged 65 years and older from 1990 to 2021: A population-based study

Abstract

Objective Epilepsy remains one of the most widespread and severe neurological disorders worldwide. This study aims to evaluate the burden of late-onset epilepsy (LOE) and investigate its temporal trends and inequalities among older adults at global, regional, and national scales between 1990 and 2021. Methods This analysis utilizes data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Temporal trends in the age-standardized prevalence rate (ASPR), incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years (DALYs) rate for LOE were quantified through the calculation of average annual percentage change over the study period. Results In 2021, the global ASPR and ASIR of LOE in adults aged 65 and older were estimated at 472.74 (95% UI: 332.21 to 654.96) and 33.12 (95% UI: 18.68 to 50.29) per 100,000 population, respectively. The global ASMR was 4.76 per 100,000 population (95% UI: 3.80 to 5.26), while the age-standardized DALYs rate reached 189.08 per 100,000 population (95% UI: 137.47 to 259.90). Among the five sociodemographic index (SDI) regions, high-SDI areas exhibited the greatest ASPR, ASIR, ASMR, and age-standardized DALY rate, whereas high-middle SDI regions reported the lowest. Geospatially, Andean Latin America recorded the highest ASPR, while Western Europe reported the highest ASIR. The highest ASMR and age-standardized DALY rate were observed in Central and Eastern Sub-Saharan Africa, respectively. Among 204 countries, Equatorial Guinea displayed the highest ASPR, while Germany had the highest ASIR. Notably, Zambia exhibited both the highest ASMR and age-standardized DALY rate for LOE. However, the inequalities associated with the SDI across countries gradually diminished over time. Conclusions The study suggest that regions with high SDI continued to experience elevated ASPR, ASIR, ASMR, and age-standardized DALY rates. These findings highlight the importance of integrating LOE care into health systems, particularly for adults aged 65 years and older.