To explore the bidirectional relationship of late-onset epilepsy (LOE) with dementia and Alzheimer’s disease (AD). Using the common electronic databases, including PubMed, Cochrane Library databases and EMBASE, we systematically reviewed published cohort studies that assessed the risk of LOE in individuals comorbid with dementia or AD, and those with dementia or AD comorbid with LOE that had been published up to 31 March 2023. The data extraction process was carried out independently by two authors. The summary adjusted relative ratio (aRR) was calculated by employing Rev Man 5.3 for the inclusion of studies. To investigate the origins of heterogeneity, we conducted both subgroup and sensitivity analyses. In the presence of heterogeneity, a random-effects model was employed. To evaluate potential publication bias, we utilized the funnel plot and conducted Begg’s and Egger’s tests. We included 20 eligible studies in the final analysis after a rigorous screening process. Pooled results indicated that LOE was association with an increased risk of all-cause dementia (aRR: 1.34, 95% confidence interval [CI]: 1.13–1.59) and AD (aRR: 2.49, 95% CI: 1.16–5.32). In addition, the pooled effect size for LOE associated with baseline AD and all-cause dementia were 3.51 (95% CI: 3.47–3.56) and 2.53 (95% CI: 2.39–2.67), respectively. Both sensitivity and subgroup analyses showed that these positive correlations persisted. According to the results of the Egger’s and Begg’s tests, as well as visual inspection of funnel plots, none of the studies appeared to be biased by publication. The findings suggested that LOE is a potential risk factor for dementia and AD, and vice versa, dementia and AD are both potential risk indicators for LOE. Since there is substantial heterogeneity among the cohorts analyzed and more cohort studies should be conducted to confirm the correlations found in the current study.

中文翻译：

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晚发性癫痫（LOE）与痴呆之间的双向关系：队列研究的系统回顾和荟萃分析

探讨迟发性癫痫 (LOE) 与痴呆和阿尔茨海默病 (AD) 的双向关系。使用公共电子数据库，包括 PubMed、Cochrane 图书馆数据库和 EMBASE，我们系统地回顾了已发表的队列研究，这些研究评估了痴呆或 AD 共病个体的 LOE 风险，以及痴呆或 AD 共病 LOE 的风险，这些研究已发表至2023 年 3 月 31 日。数据提取过程由两位作者独立进行。采用 Rev Man 5.3 计算纳入研究的汇总调整相对比 (aRR)。为了研究异质性的起源，我们进行了亚组分析和敏感性分析。在存在异质性的情况下，采用随机效应模型。为了评估潜在的发表偏倚，我们利用漏斗图并进行了 Begg 和 Egger 测试。经过严格的筛选过程，我们最终纳入了 20 项符合条件的研究。汇总结果表明，LOE 与全因痴呆（aRR：1.34，95% 置信区间 [CI]：1.13–1.59）和 AD（aRR：2.49，95% CI：1.16–5.32）风险增加相关。此外，与基线 AD 和全因痴呆相关的 LOE 的汇总效应大小分别为 3.51 (95% CI: 3.47–3.56) 和 2.53 (95% CI: 2.39–2.67)。敏感性和亚组分析均表明这些正相关性持续存在。根据艾格和贝格测试的结果，以及漏斗图的目视检查，没有一项研究似乎因发表而存在偏见。研究结果表明，LOE是痴呆和AD的潜在危险因素，反之亦然，痴呆和AD都是LOE的潜在危险指标。由于分析的队列之间存在很大的异质性，因此应该进行更多的队列研究来确认当前研究中发现的相关性。