The Status Of Cognition Impairment And Its Correlation Between Sleep Quality,Anxiety And Depression In Adult Patients With Epilepsy In Northeast Sichuan

Objective:1.To survey the demographic and clinical characteristics in adult patients with epilepsy in northeast Sichuan.2.To investigate the prevalence of cognitive impairment in the adult patients with epilepsy in this region.3.To analyse the possible factors of cognitive impairment and to proble into the correlation between the cognitive impairment and sleep quality,anxiety,as well as depression in this population with epilepsy from northeast Sichuan.Methods:A total of 100 definite clinical diagnosed epilepsy from the Department of Neurology of affiliated Hospital of North Sichuan Medical College were recruited in this cross-sectional study between January 2021 and December 2021.The Montreal Cognitive Assessment(MoCA)was used to evaluate the cognitive function.Sleep quality was evaluated using Pittsburgh Sleep Quality Index(PSQI)and the degree of sleep disturbance was assessed using the Insomnia Severity Index(ISI).Hamilton Depression Scale(HAMD)was used to evaluate depression.Hamilton Anxiety Scale(HAMA)was used to assess the anxiety status.Social Support Rating Scale(SSRS)was used to assess the level of social support.The scores of all scale were counted and analyzed.Results:(1)The prevalence of cognitive impairment in adult patients with epilepsy in northeast Sichuan was 66.00%.(2)The scores of MoCA,visual-spatial execution,naming,attention,language,abstraction,delayed recall and orientation in the epilepsy patients with cognitive impairment were lower than in those without cognitive impairment(P<0.05).(3)Univariate analysis showed that age,education level,residence,occupation,age at onset,status epilepticus,AEDs,number of AEDs,HAMD,HAMA,SSRS,subjective support and utilization of supporters were correlated with MoCA scores(P<0.05).The severity of insomnia was negatively correlated with attention(P<0.05),disease course was negatively correlated with delayed recall(P<0.05),seizure frequency was negatively correlated with language(P<0.05),and objective support was positively correlated with language(P<0.05).PSQI was positively correlated with anxiety and depression(P<0.05).(4)Multiple linear regression analysis showed that HAMD and education level were the predictors of MoCA scores in adult patients with epilepsy.Conclusion:Cognitive impairment is one of the common comorbidities in adult patients with epilepsy in northeast Sichuan province,and it displays in multiple fields with different severity.Cognitive function is affected by a variety of factors,among which HAMD and education level are the predictive factors of MoCA scores.Although there was no correlation between sleep quality and MoCA scores of epilepsy patients,but insomnia severity was negatively correlated with attention,and sleep quality was correlated with anxiety and depression.Our results suggest that we should not only reduce the harm brought by epileptic seizures to patients in the future clinical work,but also attach importance to discrimination of mental and psychological comorbidity and early intervention,give patients more social support and help,so as to improve the cognitive function,and further improve their quality of life.