Epilepsy in Older People in Sub-Saharan Africa: A Systematic Review

Background: Over one-fourth of new onset epilepsy occurs after age 60. However, the burden of epilepsy and other seizure disorders among this special population in Africa is largely unknown, despite a growingnumber of elderly persons on the continent. This study aimed to assess the prevalence and risk factors for epilepsy among persons aged 60 years or older in Africa.

Methods: We conducted a systematic review by searching MEDLINE (via) and EMBASE databases from inception to 30th October 2020. Primary researches reporting prevalence or incidence of seizures or epilepsy in older persons (≥60 years) were included. Review articles were excluded.

Results: We retrieved 107 citations from which 4 studies, recruiting 10, 334 participants were eligible. The studies were conducted between 1999 and 2018 and published between 2005 and 2019. Two of the studies were conducted in the West African countries of Niger and Senegal; meanwhile, the remaining 2 were conducted in East African country of Tanzania. Regarding study design, three were either hospital-based or community-based cross-sectional studies. Meanwhile, 1 was a retrospective hospital-based study. Of the 10,334 participants, 81 (0.78%) had a seizure disorder. The prevalence of seizure ranged from 0.02% to 3.2%.

Conclusion: There are limited data on the prevalence of epilepsy in older persons in older adults in most countries in sub-Saharan Africa. Epilepsy among the older adults remains a challenge in Africa and more information is needed to understand the burden to improve care.