The association of seizure control with neuropathology in dementia

Seizures in people with dementia (PWD) are associated with faster cognitive decline and worse clinical outcomes. However, the relationship between ongoing seizure activity and postmortem neuropathology in PWD remains unexplored. We compared post-mortem findings in PWD with active, remote, and no seizures using multicentre data from 39 Alzheimer's Disease Centres from 2005 to 2021. PWD were grouped by seizure status into active (seizures over the preceding one year), remote (prior seizures but none in the preceding year), and no seizures (controls). Baseline demographics, cognition, mortality, and postmortem findings of primary and contributing(co-pathologies) Alzheimer's Disease(AD), Frontotemporal lobar degeneration(FTD), Lewy body, vascular pathologies and neurodegeneration were compared among the groups using Pearson's Chi-squared test, fisher's exact test, t-test, and ANOVA tests. Of 10,474 deceased PWD, active seizure participants suffered the highest mortality among the groups(proportion deceased among the groups: active=56%remote=35%, controls=34%, p