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65/100

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

Topic: Risk, prevention and care in population studies

Plain-language summary

Of the 14 685 participants (7355 female [50%] and 7330 male [50%]; mean [SD] age, 73.8 [8.5] years) who met the inclusion criteria, 221 participants (1.5%) developed LOE during follow-up. After adjusting for demographics, cardiovascular risks, neurologic comorbidities, genetics, cognitive factors, and depression, the following were associated with a higher risk of developing LOE: APOE4 allele (adjusted hazard ratio [aHR], 1.39; 95% CI, 1.04-1.86; P = .03), dementia onset before age 60 years (aHR, 2.46; 95% CI, 1.53-3.95; P < .001), worse cognition (aHR, 2.35; 95% CI, 1.97-2.79; P < .001), AD dementia subtype (aHR, 1.68; 95% CI, 1.13-2.49; P = .01), stroke/TIA (aHR, 2.03; 95% CI, 1.37-3.01; P < .001), and PD (aHR, 2.53; 95% CI, 1.08-5.95; P = .03). In sensitivity analysis, using an alternative LOE definition of epilepsy onset after age 65 years revealed the same factors associated with LOE. Conclusion and Relevance: This study showed that the APOE4 allele, dementia onset before age 60 years, AD dementia subtype, worse cognition, stroke/TIA, and PD are associated with LOE development in PWCD. PWCD with these risk factors may be considered for routine screening with an electroencephalogram for early identification of LOE.

What this study adds

Evidence grade: Moderate

This is a follow-up (cohort) study of 713 participants. This longitudinal study examined risk factors for late-onset epilepsy in people with dementia or mild cognitive impairment. Reported effect size: 1.5%.

Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Zawar, I., Quigg, M., Johnson, E. L., Ghosal, S., Manning, C. A., & Kapur, J. (2025). Risk Factors Associated With Late-Onset Epilepsy in Dementia and Mild Cognitive Impairment. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.0552

Vancouver

Zawar I, Quigg M, Johnson EL, Ghosal S, Manning CA, Kapur J. Risk Factors Associated With Late-Onset Epilepsy in Dementia and Mild Cognitive Impairment. JAMA Neurology. 2025. doi:10.1001/jamaneurol.2025.0552. PMID: 40227723.

BibTeX

@article{zawar2025-40227723,
  author  = {Zawar, Ifrah and Quigg, Mark and Johnson, Emily L. and Ghosal, Soutik and Manning, Carol A. and Kapur, Jaideep},
  title   = {{Risk Factors Associated With Late-Onset Epilepsy in Dementia and Mild Cognitive Impairment}},
  journal = {JAMA Neurology},
  year    = {2025},
  doi     = {10.1001/jamaneurol.2025.0552},
  pmid    = {40227723},
  url     = {https://doi.org/10.1001/jamaneurol.2025.0552}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record lists 713 participants. Ask whether that is enough for the question, and who they were.
Effect: the record reports “1.5%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Of the 14 685 participants (7355 female [50%] and 7330 male [50%]; mean [SD] age, 73.8 [8.5] years) who met the inclusion criteria, 221 participants (1.5%) developed LOE during follow-up.
After adjusting for demographics, cardiovascular risks, neurologic comorbidities, genetics, cognitive factors, and depression, the following were associated with a higher risk of developing LOE: APOE4 allele (adjusted hazard ratio [aHR], 1.39; 95% CI, 1.04-1.86; P = .03), dementia onset before age 60 years (aHR, 2.46; 95% CI, 1.53-3.95; P < .001), worse cognition (aHR, 2.35; 95% CI, 1.97-2.79; P < .001), AD dementia subtype (aHR, 1.68; 95% CI, 1.13-2.49; P = .01), stroke/TIA (aHR, 2.03; 95% CI, 1.37-3.01; P < .001), and PD (aHR, 2.53; 95% CI, 1.08-5.95; P = .03).
In sensitivity analysis, using an alternative LOE definition of epilepsy onset after age 65 years revealed the same factors associated with LOE.
Conclusion and Relevance: This study showed that the APOE4 allele, dementia onset before age 60 years, AD dementia subtype, worse cognition, stroke/TIA, and PD are associated with LOE development in PWCD.
PWCD with these risk factors may be considered for routine screening with an electroencephalogram for early identification of LOE.

Why it matters

This longitudinal study examined risk factors for late-onset epilepsy in people with dementia or mild cognitive impairment. It found that the APOE4 allele, dementia onset before age 60, Alzheimer's disease dementia subtype, worse cognition, stroke or TIA, and Parkinson's disease were associated with developing late-onset epilepsy, and suggests routine EEG screening for those with these risk factors.

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Study details

Study designlongitudinal study
Participants713
Effect size1.5%
Evidence strengthModerate

How this study scored 65/100

Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for randomized / 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 longitudinal study following the same 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	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	2 / 4	713 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)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	3 / 7	Cited 24 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	8.0 citations a year over 3 year(s) since 2025
Impact for its field and year	4 / 6	Cited 15.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	2 / 4	Cited 24 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Jaideep Kapur: h-index 50 (OpenAlex, whole career)
Institution's track record	2 / 3	Johns Hopkins University: institution h-index 2,306 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 40227723)
Free to read	2 / 2	Free to read
Total	65 / 100	—

What each of these 20 components measures, and what this score is not →

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