Prevalence and Incidence of Epilepsy in an Elderly and Low-Income Population in the United States.
Prevalence and Incidence of Epilepsy in an Elderly and Low-Income Population in the United States.
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DOI：
10.3988/jcn.2015.11.3.252
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Labiner DM
中科院分区：
文献类型：
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作者：
Tang DH;Malone DC;Warholak TL;Chong J;Armstrong EP;Slack MK;Hsu CH;Labiner DM
本研究的目的是估计癫痫在美国老年人和贫困人群中的发病率和患病率。2008年1月1日至2010年12月31日的亚利桑那州医疗补助索赔数据用于本分析。年龄≥65岁且在2008年1月1日至2009年12月31日期间连续参加亚利桑那州医疗补助计划（低收入患者符合条件）≥12个月的受试者被认为有资格纳入研究队列。除了符合上述标准外，事件和流行病例必须有癫痫相关的医疗保健索赔。此外，事故个案须在紧接索引日期前有一年的“洁净期”。采用负二项回归和logistic回归模型评估与癫痫发病率和患病率相关的因素。2009年这一人群的癫痫发病率和患病率估计分别为每1000人年7.9例和19.3例。伴有癫痫潜在危险因素的合并症患者的发病率和患病率明显高于无合并症的老年患者（p<0.05）。非西班牙裔黑人和男性受益人的患病率分别显著高于非西班牙裔白人和女性受益人（p<0.05）。与美国普通人群相比，该患者人群癫痫发病率和患病率较高。这些差异可能至少部分归因于他们较低的社会经济地位。
The purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged ≥65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for ≥12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. The estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05). This patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status.