Update from the European Academy of Neurology meeting in Geneva (2026)
The incidence of epilepsy rises with age, meaning new cases of seizures and epilepsy are more common in older adults. This reflects several factors, including a higher risk of cerebrovascular disease such as stroke. Dementia disorders, including Alzheimer’s disease, are also more common in older adults.
Late-onset epilepsy and dementia can overlap and it can be clinically difficult to distinguish brief focal seizures from behavioural changes associated with dementia. People with dementia are at higher risk of seizures—about 2.5 times more likely than those without dementia—and evidence suggests that people with both dementia and seizures may experience faster cognitive decline than those with dementia alone.
Both epilepsy and dementia can be viewed as network disorders, involving disrupted circuits of neurons that may share underlying pathophysiological pathways. At the cellular level, changes in cellular DNA may increase neural hyperexcitability, making seizures more likely.
Studies assessing whether anti-seizure medications can slow dementia progression have not shown benefit. However, it remains possible that other types of anti-seizure medication could be beneficial.
In selected cases it may be appropriate to trial treatment for possible focal seizures with selected anti-seizure medications, and anti-seizure medications may have other benefits including mood stabilisation. However, there is currently no evidence that medications used to treat dementia affect epilepsy.
