Epilepsy spares no age group. Although epilepsy is often considered a disorder of childhood, it can begin at any age, and in some people it persists from childhood to old age. The rate of newly diagnosed epilepsy is actually higher in elderly people than in middle-aged adults. In fact, as we get older, the possibility of having seizures continues to increase. An 85 year old person is almost three times more likely than a 70 year old to develop seizures.
As with younger people, the cause of epilepsy in an elderly person cannot be determined in about half of cases. Of those in whom the cause can be determined, the largest number of cases (about 33%) are caused by stroke, often a small stroke that did not cause other symptoms.
Other causes of epilepsy in the elderly are degenerative disorders, such as Alzheimer’s disease (11%), tumors, either benign or malignant (5%), head injury (2%), and infection (1%).
The elderly are more sensitive than younger people to a variety of mental, physical, and environmental stressors. They are also more likely to develop many medical, neurological, and psychiatric disorders, some of which can increase the chance of developing seizures. Such disorders include metabolic changes such as very high or very low blood sugar, very low sodium levels, and endocrine disorders (e.g., thyroid or parathyroid disorders, diabetes). Elderly persons are also prone to falls. Approximately one-third of those over age 65 years will fall at least once each year. Many of these falls are associated with head injury, which can make seizures more likely and contribute to cognitive and behavioral problems.