A pioneering nationwide study has mapped epilepsy incidence among older adults in the United States, identifying significant regional disparities and key associated factors. Published in JAMA Neurology, the study was conducted by researchers from the Houston Methodist Research Institute and Case Western Reserve University. It revealed that epilepsy cases among adults aged 65 and older are markedly higher in the southern regions, including Louisiana, Mississippi, East Texas, and central Oklahoma.
According to the U.S. Centers for Disease Control and Prevention, epilepsy affects approximately 3.3 million people in the United States, with healthcare spending on epilepsy and seizures reaching $24.5 billion in 2019. The study’s lead investigator, Dr. Weichuan Dong of Houston Methodist DeBakey Heart & Vascular Center and Case Western Reserve University, emphasised the importance of these findings. “By applying advanced geospatial mapping to Medicare data, we revealed striking clusters of high epilepsy rates across parts of the South — what we call the ‘epilepsy belt.’ Understanding where the burden lies is the first step toward uncovering why and helping communities reduce risk.”
The research identified several influential factors linked to higher epilepsy incidence, including insufficient sleep, extreme heat, lack of physical activity, absence of health insurance among younger adults, and limited access to a household vehicle. These conditions, often shaped by local environments and socioeconomic status, were more prevalent in the regions with the highest epilepsy rates.
Dr. Siran Koroukian from Case Western Reserve University highlighted the novel association found in the study: “This is the first study documenting such a strong association between extreme heat and incident epilepsy in older adults across the U.S., highlighting the importance of climate change in emergency preparedness, especially given the graying of the population.”
Using advanced geospatial machine learning algorithms, researchers analysed data from 4.8 million Medicare beneficiaries between 2016 and 2019. Data sources included the U.S. Medicare Master Beneficiary Summary File and the Agency for Healthcare Research and Quality. Alaska and Hawaii were excluded due to incomplete data. The study uncovered previously invisible patterns in national data, showing how factors like neighbourhood sleep habits, heat exposure, healthcare access, and household vehicle access can influence health outcomes. Other strong predictors included obesity prevalence and the availability of primary care physicians.
The study involved collaboration from Alex Cabulong, Long Vu, Hannah Fein, Nicolas Schiltz, and Martha Sajatovic from Case Western Reserve University; Sadeer Al-Kindi from Houston Methodist Heart and Vascular Center; David Warner from the University of Alabama at Birmingham and Bowling Green State University; and Gena Ghearing from Mount Sinai Health System. The research was supported in part by a grant from the Centers for Disease Control and Prevention and the Center for Family and Demographic Research, Bowling Green State University. Additional support came from the Health Systems Management Center Leadership Fund at Case Western Reserve University.
