Imagine facing not just one, but two debilitating conditions in your later years: epilepsy and dementia. It’s a harsh reality for many older adults, yet surprisingly, there’s a glaring lack of support programs tailored to their unique needs. But here’s where it gets controversial: while we’ve made strides in treating both conditions individually, the intersection of epilepsy and dementia remains a mystery, leaving countless individuals and their caregivers struggling in silence. A groundbreaking initiative from the Cleveland Clinic aims to change that.
Enter the Healthy Aging in People with Epilepsy Program (HAP-E), a pilot project designed to tackle the dual challenges faced by older adults living with epilepsy, including the heightened risk of dementia, lifestyle adjustments, and strategies to manage cognitive decline. Led by neuropsychologist Dr. Anny Reyes, this program is backed by a $1 million grant from the National Institutes of Neurological Disorders and Stroke. Its mission? To empower patients with knowledge and tools to enhance self-management and quality of life.
And this is the part most people miss: the relationship between epilepsy and dementia isn’t one-sided. Research shows that individuals with epilepsy are three to four times more likely to develop Alzheimer’s disease later in life. Conversely, having Alzheimer’s or other age-related dementias increases the risk of seizures. Yet, this bidirectional link remains poorly understood. ‘It’s a relatively new field, and we urgently need more research,’ Dr. Reyes emphasizes. Her own work, published in prestigious journals like Annals of Neurology and Frontiers in Neurology, underscores the importance of this emerging area.
Despite the staggering numbers—nearly 1 million older Americans with active epilepsy and over 5.8 million with dementia—resources for those managing both conditions are scarce. ‘We’re not just addressing epilepsy; we’re equipping patients and caregivers with tools to tackle coexisting dementia and cognitive impairment,’ Dr. Reyes explains. This gap in care is what HAP-E aims to fill.
The program will feature weekly small-group sessions covering critical topics such as early dementia warning signs, lifestyle risk factors, seizure management, and coping with cognitive changes. Patient and caregiver feedback will shape the program, with sessions slated to begin in fall 2026. The team will also measure outcomes, focusing on patient satisfaction, dementia knowledge, and quality-of-life improvements. Dr. Reyes hopes to serve 80 participants over two years, with aspirations to integrate HAP-E into the national Managing Epilepsy Well Network, making it accessible to epilepsy centers nationwide.
Here’s the controversial question: Why are patients with a history of seizures often excluded from Alzheimer’s clinical trials? This exclusion creates a data void, leaving providers hesitant to prescribe amyloid-targeting drugs to epilepsy patients who might benefit. From an epilepsy research perspective, the focus on pediatric and younger adult populations leaves older adults underserved, with gaps in treatment safety and dementia risk understanding.
As the geriatric population grows, so will the number of older adults with epilepsy and cognitive decline. ‘This project is our chance to better serve this overlooked group,’ Dr. Reyes concludes. But what do you think? Is enough being done to address this dual challenge? Share your thoughts in the comments—let’s spark a conversation that could drive change.
