Cognitive Impairment Among People with Epilepsy in Peru
- 1UC Davis Health
Abstract
ObjectiveCognitive impairment is a common comorbidity among people with epilepsy (PWE) and is associated with disability and reduced quality of life. We characterized the burden of cognitive impairment and identified factors associated with cognitive performance in a large, population-based cohort of PWE living in Northern Peru, a region highly endemic for Taenia solium where neurocysticercosis (NCC) is a common cause of acquired epilepsy.
MethodsPWE enrolled in a population-based cohort in Northern Peru between 2007 and 2020 completed the Mini-Mental State Examination (MMSE) at enrollment. Cognitive impairment was defined as an MMSE score <24. Demographic and clinical data, including epilepsy characteristics and NCC status, were collected. Negative binomial regression was used to identify factors associated with the number of MMSE errors.
ResultsAmong 764 participants, the mean MMSE score was 26.4 (SD 4.2), and 16.4% met criteria for cognitive impairment. Memory and attention were the most affected domains. In multivariable analysis, older age and lower educational attainment were independently associated with poorer cognitive performance.
ConclusionIn this large, community-based cohort from Northern Peru, approximately 1 in 6 PWE had abnormal global cognition on the MMSE, with memory and attention most affected. These findings underscore the importance of incorporating cognitive evaluation and management into comprehensive epilepsy care, particularly in resource-limited settings where cognitive morbidity may be underrecognized. Given the potential for cognitive difficulties to compound disability and adversely affect quality of life, identifying and addressing cognitive morbidity may be especially important in populations already facing substantial barriers to epilepsy care.
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BibTeX
@misc{allen2026cognitive,
title = {{Cognitive Impairment Among People with Epilepsy in Peru}},
author = {S. E. Allen and C. Phillips and M. T. Wardle and L. M. Moyano and J. A. Bustos and L. L. Rojas and N. Reto and L. M. Bolivar and S. O'Neal and H. H. Garcia and Cysticercosis Working Group in Peru (CWGP)},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.28.26361672},
url = {https://www.medrxiv.org/content/10.64898/2026.08.28.26361672v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Cognitive Impairment Among People with Epilepsy in Peru
AU - S. E. Allen
AU - C. Phillips
AU - M. T. Wardle
AU - L. M. Moyano
AU - J. A. Bustos
AU - L. L. Rojas
AU - N. Reto
AU - L. M. Bolivar
AU - S. O'Neal
AU - H. H. Garcia
AU - Cysticercosis Working Group in Peru (CWGP)
PY - 2026
DA - 2026/08/28
PB - medRxiv
DO - 10.64898/2026.08.28.26361672
UR - https://www.medrxiv.org/content/10.64898/2026.08.28.26361672v1
AB - ObjectiveCognitive impairment is a common comorbidity among people with epilepsy (PWE) and is associated with disability and reduced quality of life. We characterized the burden of cognitive impairment and identified factors associated with cognitive performance in a large, population-based cohort of PWE living in Northern Peru, a region highly endemic for Taenia solium where neurocysticercosis (NCC) is a common cause of acquired epilepsy. MethodsPWE enrolled in a population-based cohort in Northern Peru between 2007 and 2020 completed the Mini-Mental State Examination (MMSE) at enrollment. Cognitive impairment was defined as an MMSE score <24. Demographic and clinical data, including epilepsy characteristics and NCC status, were collected. Negative binomial regression was used to identify factors associated with the number of MMSE errors. ResultsAmong 764 participants, the mean MMSE score was 26.4 (SD 4.2), and 16.4% met criteria for cognitive impairment. Memory and attention were the most affected domains. In multivariable analysis, older age and lower educational attainment were independently associated with poorer cognitive performance. ConclusionIn this large, community-based cohort from Northern Peru, approximately 1 in 6 PWE had abnormal global cognition on the MMSE, with memory and attention most affected. These findings underscore the importance of incorporating cognitive evaluation and management into comprehensive epilepsy care, particularly in resource-limited settings where cognitive morbidity may be underrecognized. Given the potential for cognitive difficulties to compound disability and adversely affect quality of life, identifying and addressing cognitive morbidity may be especially important in populations already facing substantial barriers to epilepsy care.
ER -