POPULATION BASED STUDY OF SEIZURES IN BLACKS AND WHITES

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Seizures and epilepsy are among the most common neurologic disorders in the elderly. Seizure can occur in many ways, including uncontrollable tonic and/or clonic jerks and/or a momentary loss of consciousness and/or altered mental state. The etiology of the seizure may be recognized (symptomatic) or unrecognized (idiopathic/cryogenic), and the initial event may occur at any stage of life. Classification schemes for epileptic seizures according to clinical and EEG features and recognized syndromes have been proposed that allows comparison of results across studies. To date, however, few studies have been focused on non-Caucasians or on the elderly. The goal of this population-based study is to determine the prevalence and incidence of seizures and epilepsy among older African-Americans and Caucasians participating in the ARIC (Atherosclerosis Risk in Communities) study. We propose to analyze data collected as part of the ARIC study, a prospective cohort study consisting of 15,792 free-living residents from Forsyth County, NC, Jackson, MS, Minneapolis/St. Paul, MN, and Washington County, MD. The ARIC baseline examination was conducted between 1987-1989, during which trained interviewers collected information on medical history and risk factors, blood pressure measurements, pulmonary function studies, and other associated measurements. Data from the second ARIC visit (1990- 1992) have similarly been collected. ARIC visit three data are currently being collected (1993-1995), and ARIC visit four data will be collected during the period of this study (1996-1999). Using these data, we propose to (1) Determine the frequency of seizures by estimating the prevalence in this populations bey ethnicity and describing the prevalence within subgroups defined by age, sex, and location; (2) Compare the prevalence with respect to selected epilepsy and VCD risk factors; and (3) Determine the incidence of seizures among this population of African-American and Caucasians. Age- adjusted incidence rates by sex and by ethnic group will be estimated and we will compare the cumulative incidence rates in ARIC with that in Rochester, MN. This study focuses on two understudied groups with respect to seizures -- the elderly and African-Americans. Studies of the prevalence and incidence of seizures in the ARIC data, especially when coupled with the extensive, already collected, CVD risk factor data, can provide data of importance to understanding the etiology of seizures and epilepsy, and complement the medical information obtained in other projects.