Subjective cognition is linked to everyday functioning in epilepsy

Author:

Hohmann Louisa12ORCID,Berger Justus2,Kastell Shirley‐Uloma2,Holtkamp Martin12ORCID

Affiliation:

1. Department of Neurology, Berlin‐Brandenburg Epilepsy Center Charité – Universitätsmedizin Berlin Corporate Member of Free University and Humboldt University of Berlin Berlin Germany

2. Epilepsy‐Center Berlin‐Brandenburg, Institute for Diagnostics of Epilepsy Queen Elisabeth Herzberge Protestant Hospital Berlin Germany

Abstract

AbstractObjectiveMany people with epilepsy (PWE) suffer from reduced everyday functioning such as unemployment, relationship difficulties, or lifestyle limitations. To identify whether subjective cognitive impairment (SCI) is a potential source of these impairments, associations with restrictions of daily life (RDL) and reduced daily activities (DA) were examined.MethodsIn a prospective cross‐sectional sample of 316 adult in‐patients with epilepsy, multiple regression analyses were calculated predicting RDL and DA. The relationships between these two measures and SCI were controlled for age, sex, seizure frequency, presence of structural lesions, epilepsy duration, mono‐ vs polytherapy and adverse events of antiseizure medication (ASM), level of depressive and anxiety symptoms, education, and employment. We also checked for an interaction between depressive symptoms and SCI, to evaluate whether patients with more depressive symptoms are more vulnerable for unfavorable associations between SCI and RDL or DA, respectively. General dominance indices (GDIs) were calculated to compare predictors.ResultsSubstantial SCI was present in 46% of our sample. SCI was independently associated with RDL and DA. Comparison of relative predictor importance revealed that SCI accounted for 23% of the total variance of RDL (GDISCI = 0.12,  = 50%) and 24% of the total variance of DA (GDISCI = 0.08,  = 32%). SCI was among the two most important predictors in both models. PWE with more depressive symptoms had stronger associations between SCI and RDL or DA, respectively.SignificanceSubjective cognitive impairment represents a frequent concern in PWE and may have detrimental consequences for their everyday life. PWE with depressive symptoms may be at greater risk of unfavorable relationships between SCI and everyday functioning. Exchange and collaboration between professionals offering psychotherapeutic, neuropsychological, and psychosocial interventions are crucial to address the patients' individual needs.

Publisher

Wiley

Subject

Neurology (clinical),Neurology

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