Quality of life predictors in patients with epilepsy and cognitive disabilities

PurposeWe aimed to assess the QOL and its predictors in Bulgarian patients with refractory epilepsy (RE) and cognitive problems.MethodsWe conducted a study based on questionnaires designed for people with intellectual disability (the stigma scale, the Glasgow Depression Scale, the Glasgow Anxiety Scale, the Glasgow Epilepsy Outcome Scale – GEOS-35) and a purposeful interview on clinical and social factors of 64 patients (50% men) with RE and cognitive problems.ResultsThe mean total score of the GEOS-35 was 76 ± 2.34 (an indicator of low QOL). On univariate analysis, the GEOS-35 total score was associated with seizure frequency and severity, stigma, depression, and anxiety. On multivariate regression analysis predictors of the GEOS-35 total score were anxiety, seizure severity, and stigma Р < 0.001 (F = 14.66). Regarding the GEOS-35 subscales, on multivariate regression analysis, we found that 1. Seizure severity, seizure type, and anxiety were predictors of “concerns about seizures” Р < 0.001 (F = 8.99); 2. Anxiety was the only predictor of “concerns about treatment” Р < 0.001 (F = 7.98); 3. Anxiety and seizure severity were predictors of “concerns about caring” Р < 0.001 (F = 12.12); and 4. Seizure severity and stigma were predictors of “concerns about social impact” Р < 0.001 (F = 18.31).ConclusionsWe have affirmed the low QOL in patients with RE and cognitive problems and its clinical and social determinants. The results from our study prove the necessity of a multidisciplinary approach for quality of life improvement in these patients.