Bone health in adults with epilepsy

Abstract

Epilepsy has been associated with an increased fracture risk by various studies in the literature. This is attributed to the decreased bone mineral density (BMD) linked to the anti–epileptic drugs (AEDs) that are used to control seizures. As increasing age is also associated with decreasing BMD, older adults with epilepsy are at particular risk for fracture. There is no consensus on managing this risk and many epilepsy care guidelines do not address the risk at all. This is understandable considering the lack of adequate research on counteractive measures in this specific population. Moreover, though a prevailing theory explains the observed decreased BMD to be a result of AEDs reducing active vitamin D levels, the efficacy of vitamin D supplementation as a protective measure does not have robust evidence nor is there an agreed upon treatment regimen. The proposed project will aim to fill the gaps in the research and establish groundwork for future research on prevention and treatment by: examining the existing literature on vitamin D supplementation for bone health in adults with epilepsy; investigating the prevalence of osteoprotective behaviours and their impact on fracture occurrence in older Canadian adults with and without epilepsy; and determining the prevalence of vitamin D supplementation in the older adult Canadian epileptic population.