The Effect of Age of Onset on Cognitive Functions in Epilepsy: A Systematic Review

Abstract

Epilepsy is a chronic neurological disorder often associated with significant cognitive and psychological challenges. This systematic review examined the effect of age of onset on cognitive functions, focusing on domains such as memory, attention, executive function, and intelligence. Following PRISMA guidelines, 12 studies published between 2010 and 2025 were analyzed. The findings revealed that early-onset epilepsy often disrupts neurodevelopmental processes, leading to persistent deficits in attention, executive control, and intellectual function, whereas late-onset epilepsy is more influenced by psychological and treatment-related factors such as anxiety and polytherapy. Across age groups, cognitive impairments in epilepsy reflect both neurological and psychosocial mechanisms, underscoring the need for early assessment, targeted interventions and integrated management approaches.