Title: Prevalence, Incidence, and Associated Antiepileptic Drug Use in Autistic Adults in a State Medicaid System
Legend: The figure displays prevalence, incidence, and associated antiepileptic drugs use in Medicaid beneficiaries with autism spectrum disorder and intellectual disability. Epilepsy was prevalent in 11.1% of autistic adults without intellectual disability, 34.6% of autistic adults with intellectual disability, and 27.0% of adults with intellectual disability alone. Incidence was 11.1 per 1000 person years for autistic adults without intellectual disability, 23.6 per 1000 person years for autistic adults with intellectual disability, and 15.9 per 1000 person years for adults with intellectual disability. More than 25% of autistic adults without ID and 20% of autistic adults with ID had claims for epilepsy and did not have claims for antiepileptic drugs. In all groups, antiepileptic drugs were most often prescribed to individuals without claims for epilepsy.
Citation: Bishop, L., McLean, K. J., & Rubenstein, E. (2020). Epilepsy in adulthood: Prevalence, incidence, and associated antiepileptic drug use in autistic adults in a state Medicaid system. Autism.
Abstract: Although epilepsy commonly presents with autism in children, it is currently unknown whether established estimates represent the prevalence and incidence of epilepsy in autistic adults. Our objective was to use population-level Medicaid data to determine prevalence, incidence, and antiepileptic drug use associated with epilepsy in a unique population of autistic adults aged 21+ with (N=2,738) and without (N=4,775) intellectual disability and to compare results to adults with intellectual disability alone (N=18,429). We found that 34.6% of autistic adults with intellectual disability and 11.1% of autistic adults without intellectual disability had epilepsy, compared to 27.0% of adults with intellectual disability alone. New incidence of epilepsy was 23.6 incident cases per 1000 person years (95% CI: 21.3, 26.2) in autistic adults with intellectual disability, 7.7 incident cases per 1000 person years (95% CI: 6.6, 8.9) in autistic adults without intellectual disability, and 15.9 incident cases per 1000 person years (95% CI: 15.2, 16.7) in adults with intellectual disability alone. Female sex and intellectual disability were associated with increased risk of prevalent and incident epilepsy in autistic adults. Findings underscore the importance of treating prevalent epilepsy and screening and preventing incident epilepsy in autistic adults as they age.
About the Lab: Lauren Bishop is interested in modifiable factors that improve health equity and reduce health disparities in adults with developmental disabilities as they age. Current research projects conducted by the Aging and Health Equity in Autism and Developmental Disabilities (AHEADD) Team aim to investigate disparities in health and wellbeing adults with autism and other developmental disabilities as they age using Wisconsin Medicaid Data and linked administrative data. Dr. Bishop and the AHEADD Team are also broadly interested in education and training aimed at educating the workforce of practitioners who provide community-based services to people with developmental disabilities.