What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders

Adeel Zubair, Tess E.K. Cersonsky, Sarah Kellner, Edward D. Huey, Stephanie Cosentino, Elan D. Louis

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. Methods: In a longitudinal, prospective study of 141 elders with ET, we used Cox proportional-hazards models to estimate hazard ratios (HRs) for death. Results: The mean baseline age was 81.1 ± 8.8 years. During the follow-up interval, 27 (19.1%) died. Average time from baseline to death was 12.3 ± 8.7 months (range = 0.3–31.2). In univariate Cox regression models, older age (HR = 1.16, p < 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p < 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. Conclusions: This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.

Original languageEnglish (US)
Article number1077
JournalFrontiers in Neurology
Volume9
DOIs
StatePublished - Dec 7 2018
Externally publishedYes

Keywords

  • cognitive aging
  • cognitive impairment
  • dementia
  • depression
  • essential tremor
  • mortality

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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