Publication:

Falls in the geriatric population with epilepsy: a narrative review

Epilepsy is a common neurological disorder in older adults, with incidence rising significantly after 60 years of age. Falls represent a major source of morbidity and mortality in this population and occur more frequently in individuals with epilepsy than in age-matched controls. The increased risk is multifactorial, resulting from seizure-related events, adverse effects of antiseizure medications (ASMs), and age-related physiological changes such as impaired balance, frailty, cognitive decline, and comorbidities. Seizures may directly precipitate falls through loss of consciousness, impaired awareness, and postictal confusion, while ASMs contribute via dizziness, sedation, ataxia, and visual disturbances. Evidence from systematic reviews demonstrates a clear association between ASM use and increased fall risk in older adults. Fall-related injuries, including fractures and traumatic brain injury, lead to functional decline, reduced independence, and increased healthcare utilization. Effective management requires a multidisciplinary approach focused on optimizing seizure control, minimizing medication-related adverse effects, improving balance and mobility, and addressing environmental hazards. Early identification of high-risk individuals and implementation of targeted preventive strategies are essential to reduce fall-related complications and improve clinical outcomes in the geriatric epilepsy population.