4 ms·

We're really going to have to wait until the paper comes out to evaluate this. They compared to the general population, and there is a good chance that the part

We're really going to have to wait until the paper comes out to evaluate this. They compared to the general population, and there is a good chance that the participants in the study were severe enough to have approached a neurologist for care. That's not going to be representative if it's true. It will also matter whether the diagnostic process was rigorous. Basically...don't worry yet if you can help it.

bookofjoe 3y ago
>Essential tremor is associated with dementia: Prospective population-based study in New York (2009) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731620/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731620/ ABSTRACT Background: Mild cognitive deficits, mainly in frontal-executive function and memory, have been reported in patients with essential tremor (ET). Furthermore, an association between ET and dementia has been reported in a single population-based study in Spain. This has not been confirmed elsewhere. Objective: To determine whether baseline ET is associated with prevalent and incident dementia in an ethnically diverse, community-based sample of elders. Methods: Community-dwelling elders in northern Manhattan were enrolled in a prospective cohort study. Baseline ET diagnoses were assigned from handwriting samples. Dementia was diagnosed at baseline and follow-up using DSM-III-R criteria. Results: In cross-sectional analyses, 31/124 (25.0%) ET cases had prevalent dementia vs 198/2,161 (9.2%) controls (odds ratio [OR]unadjusted = 3.31, 95% confidence interval [CI] = 2.15–5.09, p < 0.001; ORadjusted = 1.84, 95% CI = 1.13–2.98, p = 0.01). In prospective analyses, 17/93 (18.3%) ET cases vs 171/1,963 (8.7%) controls developed incident dementia (hazard ratio [HR]unadjusted = 2.78, 95% CI = 1.69–4.57, p < 0.001; HRadjusted = 1.64, 95% CI = 0.99–2.72, p = 0.055). Conclusions: In a second population-based study of elders, essential tremor (ET) was associated with both increased odds of prevalent dementia and increased risk of incident dementia. Presence of dementia, therefore, appeared to be greater than that expected for age (i.e., a disease-associated feature). Rather than attributing cognitive complaints in patients with ET to old age, assessment and possible treatment of dementia should be routinely incorporated into the treatment plan.
- thereticent 3y ago
  Thanks. The best way to evaluate this is the prospective analysis, adjusted for control variables. The confidence interval on that hazard ratio includes 1.00, so the null hypothesis that there is no difference stands. For the cross-sectional analysis, essential tremor was associated with dementia, but it gives no information as to whether ET increases risk for later dementia vs. dementia raises risk of ET. Finally, the criteria used for dementia diagnosis are the psychiatric criteria from 4 DSM editions ago, though the criteria have been revised and updated numerous times by neurologists and other neuroscientists (i.e. those who work with essential tremor). At least the sample was community-based instead of clinic-based.
spike021 3y ago
FWIW my grandfather also had tremors and his final years had dementia. So at least for me this could be some genetic validation. We just don't know when my grandfathers tremors began. We always figured it was more of a WWII/Holocaust survivorship PTSD symptom.
- thereticent 3y ago
  Understood. It's tough not to personalize findings like this. ET is heritable and dementia is heritable to some extent, but that doesn't mean one causes the other. I'm not saying you have nothing to worry about, but this paper shouldn't make you more worried than anyone with a grandparent with dementia. My best to you.
  - spike021 3y ago
    For sure, thanks for the reassurance.

bookofjoe 3y ago

>Essential tremor is associated with dementia: Prospective population-based study in New York (2009) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731620/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731620/ ABSTRACT Background: Mild cognitive deficits, mainly in frontal-executive function and memory, have been reported in patients with essential tremor (ET). Furthermore, an association between ET and dementia has been reported in a single population-based study in Spain. This has not been confirmed elsewhere. Objective: To determine whether baseline ET is associated with prevalent and incident dementia in an ethnically diverse, community-based sample of elders. Methods: Community-dwelling elders in northern Manhattan were enrolled in a prospective cohort study. Baseline ET diagnoses were assigned from handwriting samples. Dementia was diagnosed at baseline and follow-up using DSM-III-R criteria. Results: In cross-sectional analyses, 31/124 (25.0%) ET cases had prevalent dementia vs 198/2,161 (9.2%) controls (odds ratio [OR]unadjusted = 3.31, 95% confidence interval [CI] = 2.15–5.09, p < 0.001; ORadjusted = 1.84, 95% CI = 1.13–2.98, p = 0.01). In prospective analyses, 17/93 (18.3%) ET cases vs 171/1,963 (8.7%) controls developed incident dementia (hazard ratio [HR]unadjusted = 2.78, 95% CI = 1.69–4.57, p < 0.001; HRadjusted = 1.64, 95% CI = 0.99–2.72, p = 0.055). Conclusions: In a second population-based study of elders, essential tremor (ET) was associated with both increased odds of prevalent dementia and increased risk of incident dementia. Presence of dementia, therefore, appeared to be greater than that expected for age (i.e., a disease-associated feature). Rather than attributing cognitive complaints in patients with ET to old age, assessment and possible treatment of dementia should be routinely incorporated into the treatment plan.

thereticent 3y ago
Thanks. The best way to evaluate this is the prospective analysis, adjusted for control variables. The confidence interval on that hazard ratio includes 1.00, so the null hypothesis that there is no difference stands. For the cross-sectional analysis, essential tremor was associated with dementia, but it gives no information as to whether ET increases risk for later dementia vs. dementia raises risk of ET. Finally, the criteria used for dementia diagnosis are the psychiatric criteria from 4 DSM editions ago, though the criteria have been revised and updated numerous times by neurologists and other neuroscientists (i.e. those who work with essential tremor). At least the sample was community-based instead of clinic-based.

spike021 3y ago

FWIW my grandfather also had tremors and his final years had dementia. So at least for me this could be some genetic validation. We just don't know when my grandfathers tremors began. We always figured it was more of a WWII/Holocaust survivorship PTSD symptom.

thereticent 3y ago
Understood. It's tough not to personalize findings like this. ET is heritable and dementia is heritable to some extent, but that doesn't mean one causes the other. I'm not saying you have nothing to worry about, but this paper shouldn't make you more worried than anyone with a grandparent with dementia. My best to you.
- spike021 3y ago
  For sure, thanks for the reassurance.