Epilepsy and Seizures in Older Adults

An older Caucasian woman being hugged by another woman in a kitchen. The older Caucasian woman’s face is shown. Her eyes are closed and she has a calm look on her face.

Did you know that epilepsy is more likely to develop in older adults? Seizures can be easy to miss. Learn how to recognize the signs and how you can help.

Epilepsy is brain disorder that causes repeated seizures. About 3 million US adults aged 18 years or older have active epilepsy.1 Nearly 1 million of those adults are aged 55 or older.2 As our population ages, there will be even more older people with epilepsy in the coming years.

Epilepsy is more likely to develop in older adults because some risk factors for epilepsy are more common in older adults3:

About half of older adults who are told they have epilepsy do not know the cause.4

How Do I Know If It’s Epilepsy?

An older African American woman is outdoors staring into nature with a contemplative look on her face.

Epilepsy can affect people at any age, but it's more likely to develop in older adults.

It isn’t always easy to tell when you or someone you care for develops epilepsy later in life. That’s because seizures may be hard to recognize in older adults and may go unnoticed. For example, memory problems, confusion, falls, dizziness, or sensory changes like numbness are often blamed on “getting older.”4,5 However, these can actually be signs of seizures.4,5

There are many different signs of seizures because there are many types of seizures. In the movies and on TV, a person is often shown falling to the ground, shaking, and becoming unaware of what’s going on around them. That’s one kind of seizure, but it’s not the most common. More often, a person having a seizure may:

  • Seem confused.
  • Stare into space.
  • Wander.
  • Make unusual movements.
  • Can’t answer questions or talk.

When these signs occur more than once and often in the same pattern, they could be signs of seizures.

If an older adult is showing these signs, it is important for them to talk to a health care provider. Most adults with epilepsy have good seizure control with medicines.3 Epilepsy specialists can help older adults find the right treatment. Find an epilepsy specialist near you at the Epilepsy Foundation websiteexternal icon.

A Caucasian woman has a single arm around an older Caucasian woman who is smiling.

Caregivers should learn how to recognize seizures in older adults.

How Is Epilepsy Challenging for Older Adults?

Adults who develop epilepsy later in life may have a hard time managing the disorder. Eight in 10 adults aged 65 or older have more than one chronic health condition.6 It can be hard to balance epilepsy treatment when taking medicines for other health problems. Many epilepsy medicines also have side effects such as bone loss or dizziness, which can make someone more likely to fall and become injured.4
Epilepsy can also affect a person’s daily life if seizures limit their ability to drive or if they live alone. After a lifetime of being independent, losing the ability to drive or take care of themselves can be especially hard for older adults. Read more about this in an Epilepsy Foundation article about living independentlyexternal icon.

How Can You Help?

Seizure first aid is easy to give and involves keeping the person safe until the seizure stops on its own and knowing when to call 911 for emergency help.

If you work at an adult day care center, senior center, long-term care facility, nursing home, in home health care, or another senior-serving organization, there is special training available. Seniors & Seizuresexternal icon is a free online or in-person course offered by the Epilepsy Foundation. You can get free continuing education credits for participating.

References
  1. Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy — United States, 2015. MMWR. 2017;66:821–825. DOI: 10.15585/mmwr.mm6631a1. html.
  2. Sapkota S, Kobau R, Pastula D, Zack M. Close to one million U.S. adults aged 55 years or older have active epilepsy — National Health Interview Survey 2010, 2013, and 2015. Epilepsy Behav. 2018;87:233–234. DOI: 10.1016/j.yebeh.2018.06.030. htmlexternal icon.
  3. Brodie MJ, Elder AT, Kwan. Epilepsy in later life. Lancet Neurology. 2009;8(11):1019-1030. DOI: 10.1016/S1474-4422(09)70240-6. htmlexternal icon.
  4. Waterhouse E, Towne A. Seizures in the elderly: Nuances in presentation and treatment. Cleve Clin J Med. 2005;72(3):S26-S37. DOI: 10.3949/ccjm.72.Suppl_3.S26. htmlexternal icon.
  5. Pugh MJ, Knoefel JE, Mortensen EM, Amuan ME, Berlowitz DR, Van Cott AC. New-onset epilepsy risk factors in older veterans. J Am Geriat Soc. 2009;57(2):237-42. DOI:10.1111/j.1532-5415.2008.02124.x. htmlexternal icon.
  6. Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions Chartbook. AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality; 2014. Accessed April 1, 2019. PDF pdf icon[10.6MB]external icon.

Do I Call 911?

Seizures do not usually require emergency medical attention. Only call 911 if one or more of these are true:

  • The person has never had a seizure before.
  • The person has difficulty breathing or waking after the seizure.
  • The seizure lasts longer than 5 minutes.
  • The person has another seizure soon after the first one.
  • The person is hurt during the seizure.
  • The seizure happens in water.
  • The person has a health condition like diabetes, heart disease, or is pregnant.