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65/100

✓ Peer-reviewed alzhub usefulness score 65 out of 100. Prevention and risk

Topic: Brain proteins, microglia and lab models

Stroke, dementia, and hypertension are associated with late-onset epilepsy; however, the role of other vascular and lifestyle factors remains unclear. Results Of the 10 420 total participants (5878 women [56.4%] and 2794 black participants [26.8%]; median age 55 years at first visit), 596 participants developed late-onset epilepsy (3.33 per 1000 person-years). In multivariable analysis, baseline hypertension (hazard ratio [HR], 1.30; 95% CI, 1.09-1.55), diabetes (HR, 1.45; 95% CI, 1.17-1.80), smoking (HR, 1.09; 95% CI, 1.01-1.17), apolipoprotein E ε4 genotype (1 allele HR, 1.22; 95% CI, 1.02-1.45; 2 alleles HR, 1.95; 95% CI, 1.35-2.81), and incident stroke (HR, 3.38; 95% CI, 2.78-4.10) and dementia (HR, 2.56; 95% CI, 2.11-3.12) were associated with an increased risk of late-onset epilepsy, while higher levels of physical activity (HR, 0.90; 95% CI, 0.83-0.98) and moderate alcohol intake (HR, 0.72; 95% CI, 0.57-0.90) were associated with a lower risk. Results were similar after censoring individuals with stroke or dementia. Conclusions and relevance Potentially modifiable risk factors in midlife and the APOE ε4 genotype were positively associated with risk of developing late-onset epilepsy. Although stroke and dementia were both associated with late-onset epilepsy, vascular and lifestyle risk factors were significant even in the absence of stroke or dementia.

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APA 7th

Johnson, E. L., Krauss, G. L., Lee, A. K., Schneider, A. L. C., Dearborn, J. L., Kucharska-Newton, A. M., et al. (2018). Association Between Midlife Risk Factors and Late-Onset Epilepsy: Results From the Atherosclerosis Risk in Communities Study. JAMA neurology. https://doi.org/10.1001/jamaneurol.2018.1935

Vancouver

Johnson EL, Krauss GL, Lee AK, Schneider ALC, Dearborn JL, Kucharska-Newton AM, et al. Association Between Midlife Risk Factors and Late-Onset Epilepsy: Results From the Atherosclerosis Risk in Communities Study. JAMA neurology. 2018. doi:10.1001/jamaneurol.2018.1935. PMID: 30039175.

BibTeX

@article{johnson2018-30039175,
  author  = {Johnson, E. L. and Krauss, G. L. and Lee, A. K. and Schneider, A. L. C. and Dearborn, J. L. and Kucharska-Newton, A. M. and Huang, J. and Alonso, A. and others},
  title   = {{Association Between Midlife Risk Factors and Late-Onset Epilepsy: Results From the Atherosclerosis Risk in Communities Study}},
  journal = {JAMA neurology},
  year    = {2018},
  doi     = {10.1001/jamaneurol.2018.1935},
  pmid    = {30039175},
  url     = {https://doi.org/10.1001/jamaneurol.2018.1935}
}

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Key findings

Stroke, dementia, and hypertension are associated with late-onset epilepsy; however, the role of other vascular and lifestyle factors remains unclear.
Results Of the 10 420 total participants (5878 women [56.4%] and 2794 black participants [26.8%]; median age 55 years at first visit), 596 participants developed late-onset epilepsy (3.33 per 1000 person-years).
In multivariable analysis, baseline hypertension (hazard ratio [HR], 1.30; 95% CI, 1.09-1.55), diabetes (HR, 1.45; 95% CI, 1.17-1.80), smoking (HR, 1.09; 95% CI, 1.01-1.17), apolipoprotein E ε4 genotype (1 allele HR, 1.22; 95% CI, 1.02-1.45; 2 alleles HR, 1.95; 95% CI, 1.35-2.81), and incident stroke (HR, 3.38; 95% CI, 2.78-4.10) and dementia (HR, 2.56; 95% CI, 2.11-3.12) were associated with an increased risk of late-onset epilepsy, while higher levels of physical activity (HR, 0.90; 95% CI, 0.83-0.98) and moderate alcohol intake (HR, 0.72; 95% CI, 0.57-0.90) were associated with a lower risk.
Results were similar after censoring individuals with stroke or dementia.
Conclusions and relevance Potentially modifiable risk factors in midlife and the APOE ε4 genotype were positively associated with risk of developing late-onset epilepsy.

Why it matters

In this cohort, midlife hypertension, diabetes, smoking, apolipoprotein E e4 genotype, stroke, and dementia were associated with higher risk of late-onset epilepsy, while physical activity and moderate alcohol intake were linked to lower risk. These findings are about epilepsy risk, not about treating, curing, or preventing Alzheimer's disease.

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Study details

Study designcohort study
Participants792
Effect size56.4%; 26.8%
Evidence strengthModerate

How this study scored 65/100

Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA neurology)
Journal's citation record	2 / 4	JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2018 — within 10 year(s) of the newest study here
Sample size	2 / 4	792 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 164 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	16.4 citations a year over 10 year(s) since 2018
Impact for its field and year	3 / 6	Cited 6.1× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 6 other studies in this library
Still being cited	3 / 4	Cited 93 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Rebecca F. Gottesman: h-index 92 (OpenAlex, whole career)
Institution's track record	2 / 3	Johns Hopkins University: institution h-index 2,306 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 6 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 30039175)
Free to read	0 / 2	Behind a paywall — scores zero
Total	65 / 100	—

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