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Epilepsy in immigrants and Swedish-born : A cohort study of all adults 18 years of age and older in Sweden

Wändell, Per LU ; Fredrikson, Sten ; Carlsson, Axel C. ; Li, Xinjun LU ; Gasevic, Danijela ; Sundquist, Jan LU and Sundquist, Kristina LU (2020) In Seizure 76. p.116-122
Abstract

Purpose: We aimed to study the association between country of birth and incident epilepsy in several immigrant groups using Swedish-born individuals as referents. Method: The study population included all adults aged 18 years and older in Sweden, living and deceased, 6,690,598 in the first-generation and 6,683,125 in the second-generation sub-study. Epilepsy was defined as having at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed as hazard ratios (HRs) and 95 % confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden,... (More)

Purpose: We aimed to study the association between country of birth and incident epilepsy in several immigrant groups using Swedish-born individuals as referents. Method: The study population included all adults aged 18 years and older in Sweden, living and deceased, 6,690,598 in the first-generation and 6,683,125 in the second-generation sub-study. Epilepsy was defined as having at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed as hazard ratios (HRs) and 95 % confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Results: In the first-generation sub-study, totally 76,541 individuals had at least one registered diagnosis of epilepsy (1.14 % in total; men 1.22 % and women 1.07 %), and in the second-generation study 72,545 (1.09 %; men 1.18 % and women 0.99 %). After adjusting for confounders, in first-generation immigrants compared to their Swedish-born counterparts the incidence was somewhat lower among both men (HR 0.92, 0.90-0.96) and women (HR 0.93, 0.90-0.96), and in the second-generation immigrants among women (HR 0.95, 0.92-0.99) but not men (HR 0.99; 0.96–1.02). Among immigrant groups, a higher incidence of epilepsy was observed among first-generation women from Africa and Iraq, and second-generation men and women from Bosnia, and women from Finland. Conclusions: Risk of epilepsy was lower in immigrants in general compared to the Swedish-born population; but with higher incidence in some specific groups.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epilepsy, Gender, Immigrants, Neighborhood, Socioeconomic status
in
Seizure
volume
76
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85079223568
  • pmid:32062322
ISSN
1059-1311
DOI
10.1016/j.seizure.2020.02.005
language
English
LU publication?
yes
id
10aa7f9a-6992-463b-bd0a-88ce7319e12e
date added to LUP
2020-02-20 12:38:56
date last changed
2020-02-26 07:42:20
@article{10aa7f9a-6992-463b-bd0a-88ce7319e12e,
  abstract     = {<p>Purpose: We aimed to study the association between country of birth and incident epilepsy in several immigrant groups using Swedish-born individuals as referents. Method: The study population included all adults aged 18 years and older in Sweden, living and deceased, 6,690,598 in the first-generation and 6,683,125 in the second-generation sub-study. Epilepsy was defined as having at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed as hazard ratios (HRs) and 95 % confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Results: In the first-generation sub-study, totally 76,541 individuals had at least one registered diagnosis of epilepsy (1.14 % in total; men 1.22 % and women 1.07 %), and in the second-generation study 72,545 (1.09 %; men 1.18 % and women 0.99 %). After adjusting for confounders, in first-generation immigrants compared to their Swedish-born counterparts the incidence was somewhat lower among both men (HR 0.92, 0.90-0.96) and women (HR 0.93, 0.90-0.96), and in the second-generation immigrants among women (HR 0.95, 0.92-0.99) but not men (HR 0.99; 0.96–1.02). Among immigrant groups, a higher incidence of epilepsy was observed among first-generation women from Africa and Iraq, and second-generation men and women from Bosnia, and women from Finland. Conclusions: Risk of epilepsy was lower in immigrants in general compared to the Swedish-born population; but with higher incidence in some specific groups.</p>},
  author       = {Wändell, Per and Fredrikson, Sten and Carlsson, Axel C. and Li, Xinjun and Gasevic, Danijela and Sundquist, Jan and Sundquist, Kristina},
  issn         = {1059-1311},
  language     = {eng},
  pages        = {116--122},
  publisher    = {Elsevier},
  series       = {Seizure},
  title        = {Epilepsy in immigrants and Swedish-born : A cohort study of all adults 18 years of age and older in Sweden},
  url          = {http://dx.doi.org/10.1016/j.seizure.2020.02.005},
  doi          = {10.1016/j.seizure.2020.02.005},
  volume       = {76},
  year         = {2020},
}