Higher education level as a protective factor against executive dysfunction in patients with epilepsy in Mataram, Indonesia

Since the concept of cognitive reserve is applicable in epilepsy-associated cognitive impairment, the role of cognitive reserve components as a protective factor against epilepsy-associated executive dysfunction needs further investigation. This study aimed at investigating the association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction in Mataram, Indonesia. This case-control study involved both epilepsy outpatient and healthy participants recruited consecutively in 5 hospitals in Mataram, between October 2021 and September 2022. Data on sociodemographic, cognitive reserve components, and executive function status were collected from both groups, while data on seizure were collected only from epilepsy participants. The association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction was tested using logistic regression. A total of 119 epilepsy patients and 93 healthy participants were recruited. The frequency of epilepsy-associated executive dysfunction was 50.4%. Multivariate logistic regression analysis showed that higher education level was the only cognitive reserve component protective against epilepsy-associated executive dysfunction (odds ratio [OR]: 3.36; 95% confidence interval [CI]: 1.33 – 8.50). A high frequency of epilepsy-associated executive dysfunction was observed in Mataram. Higher education level was a cognitive reserve component protective against executive dysfunction in these patients. •The frequency of executive dysfunction is higher in the epilepsy group than in the control group.•Years of education is the cognitive reserve component that protects against executive dysfunction in epilepsy patients.•Increasing age is positively associated with executive dysfunction in patients with epilepsy.