Photo Credit: Yuliya Baranych

The following is a summary of “Incident Epilepsy Among US Medicare Beneficiaries, 2019: Differences by Age, Sex, and Race/Ethnicity,” published in the September 2024 issue of Neurology by Warner et al.

Researchers conducted a retrospective study to provide updated epilepsy incidence estimates among older adults, comparing across age, sex, and race/ethnicity.

They analyzed epilepsy incidence using a random sample of 4,999,999 US Medicare beneficiaries over 65, analyzing administrative claims (2016 to 2019). The beneficiaries enrolled in the Fee-for-Service (FFS) program (2016 to 2018) had no epilepsy claims during those years. Non-Hispanic Black and Hispanic beneficiaries were oversampled to ensure sufficient cases for detailed analysis. In 2019, incidence was determined from the Master Beneficiary Summary File based on ≥1 inpatient claim or ≥2 outpatient non-drug claims at least 1 day apart (ICD-10 G40.x). Incidence models were estimated by age, sex, and race/ethnicity, adjusting for the oversampling of racial/ethnic groups.

The results showed 20,545 new epilepsy cases, and the overall epilepsy IR was 393 per 100,000 (99% CI 385–400). Incidence peaked at ages 85–89 (504 [481–529]) and was higher in men (396 [385–407]) compared to women (376 [366–385]). The sex difference in IRs remained consistent across ages. Incidence rates were elevated for non-Hispanic Black (678 [653–702]) and Hispanic (405 [384–426]) beneficiaries, while non-Hispanic Asian/Pacific Islander beneficiaries had a lower rate (272 [239–305]) compared to non-Hispanic White beneficiaries (354 [299–408]). Significant age-specific IR differences were found, with non-Hispanic Black men having higher rates in women at older ages.

Investigators concluded that older adults enrolled in Medicare FFS during 2016-2019 had a higher risk of epilepsy onset, especially those in their late 80s, men, and non-Hispanic Black and Hispanic.

Source: neurology.org/doi/10.1212/WNL.0000000000209804