Intellectual Disability and Epilepsy in Adults: cognitive trajectories and targets for care and interventions

Cognitive decline is a major clinical concern in adults with ID and epilepsy. It is thought to occur in the context of a ‘chronic
accumulation model’ in chronic and refractory epilepsies; the effects of seizures, medication and ageing on an already vulnerable
brain. However, epidemiology, phenomenology and determinants of cognitive decline are unknown as this vulnerable population is
under-researched. In the earlier study TRIANGLE (MEC 2016-408) cognitive and adaptive functioning in a group of patients with
epilepsy and intellectual disability was studied. By repeating the same measures we can compare the outcomes over time and
study the cognitive trajectory in people with intellectual disability. Furthermore, a group of participants with differing genetic
syndromes are studied for the first time. As patients with these syndromes have various degrees of epilepsy and intellectual
disability, we can study the relationship between these factors and cognitive and adaptive functioning. By adding a blood analysis,
we can study whether a possible decline in adaptive or cognitive functioning is associated with signs of neurodegeneration.
Additionally, use of serum biomarkers could eventually lead to a less burdensome way of evaluating dementia symptoms, in
comparison with lumbar puncture and MRI-scans

To investigate the trajectories of cognitive and adaptive functioning in adults with epilepsy and ID. In doing so we are looking for clinical determinants of cognitive and adaptive decline. Furthermore, the association between decline and serum biomarkers for dementia is explored.

Study 1 is a follow-up 5 years after the TRIANGLE study
Study 2 is a cross-sectional study and thus will have only 1 time point.