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Objectives The study aimed to assess the effect of demographic and clinical features of epilepsy, anxiety, depressed mood, sleep, and quality of life on the prediction of cognitive decline in patients with epilepsy. Methods Two hundred and six consecutive patients with epilepsy (age 41.8 ± 15.6 years, mean, SD) out of 279, were included in this cross-sectional study. We used simple linear regression to calculate the results. Results Objective cognitive status was predicted by anxiety and depression mood changes (Beck Anxiety Inventory