Comorbidity as an epidemiological construct

Abstract

As the implications of comorbid conditions in epilepsy are explored, 1 Keezer MR Sisodiya SM Sander JS Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol. 2016; 1: 78-91 Google Scholar it is useful to recall the context in which comorbidity was first defined and how it has been re-interpreted. This concept was first introduced by Alvan Feinstein (1925–2001) in 1970. 2 Feinstein A Pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis. 1970; 23: 455-468 Summary Full Text PDF PubMed Scopus (993) Google Scholar It arose from concern about the confounding effect that associated diseases could have on the study of interventions, at a time when medicine was moving from the investigation of infections towards chronic diseases. Co-occurrence of different conditions is amplified in the context of chronic diseases and understanding their relation is essential. Comorbidities of epilepsy: current concepts and future perspectivesThe burden of comorbidity in people with epilepsy is high. Several diseases, including depression, anxiety, dementia, migraine, heart disease, peptic ulcers, and arthritis are up to eight times more common in people with epilepsy than in the general population. Several mechanisms explain how epilepsy and comorbidities are associated, including shared risk factors and bidirectional relations. There is a pressing need for new and validated screening instruments and guidelines to help with the early detection and treatment of comorbid conditions. Full-Text PDF