[HN Gopher] Essential Tremor Linked to Tripled Risk of Dementia,...
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Essential Tremor Linked to Tripled Risk of Dementia, Study Finds
Author : bookofjoe
Score : 25 points
Date : 2024-03-09 17:57 UTC (5 hours ago)
(HTM) web link (scienceblog.com)
(TXT) w3m dump (scienceblog.com)
| taejavu wrote:
| I'd like to understand more about essential tremors - is there
| anyone here experienced in such matters and/or able to point me
| toward some good resources?
| jrpt wrote:
| First off, there's two different kinds: in young people and in
| old people (known as age-related or late-onset essential
| tremor). It's the same disorder but evidently different
| etiologies.
|
| Personally I believe it will be cured with gene editing
| someday.
|
| Also, it was already known that age-related essential tremor
| increases your risk of dementia.
| spike021 wrote:
| This is.... a bit depressing considering I have had essential
| tremor probably since I was about 12 or so years old.
| getcrunk wrote:
| Same :( Also family history of dementia and Parkinson's but I
| tested clear for Parkinson's markers
| thereticent wrote:
| 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 wrote:
| >Essential tremor is associated with dementia: Prospective
| population-based study in New York (2009)
|
| 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 wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| For sure, thanks for the reassurance.
| jrpt wrote:
| In that case, you have early onset essential tremor, not age-
| related essential tremor. I believe only age-related essential
| tremor has increased risk of dementia. For example:
|
| In an adjusted model, ET cases with tremor onset after age 65
| years were twice as likely to develop incident dementia than
| were controls (RR = 1.98, 95% CI = 1.14-3.45, P = 0.01),
| whereas ET cases with tremor onset < age 65 years and controls
| were equally to develop incident dementia (RR = 0.74, 95% CI =
| 0.19-3.20, P = 0.79).
|
| https://movementdisorders.onlinelibrary.wiley.com/doi/10.100...
|
| However, I think essential tremor needs more research in
| general.
| swatcoder wrote:
| Look, astronomically few people are at baseline or zero risk
| for _all_ ailments. Essentially everyone is genetically or
| environmentally predisposed to an increased _relative_ risk of
| some many terrible things that could befall them in the future.
|
| Some people get to know about some of those biases ahead of
| time, some people don't get to know about them at all.
|
| This is now on your list. When you're in your seventies, _and
| assuming continued research in this area doesn 't refine in a
| way that excludes your case_, you may be more likely to have
| dementia than some random person you know without ET.
| Relatively few people get diagnosed with dementia though, and
| that includes relatively few people with ET (although,
| apparently, more), so who really knows.
|
| Meanwhile, the rando that you picked to compare yourself to has
| their own known or unknown 3x risk for pancreatic cancer or
| aortic aneurism or kidney failure or something, and -- like you
| -- will _probably_ not develop that particular condition
| anyway.
|
| This should not be read as "oh shit, I'm going to develop
| dementia because of this damned ET!" so much as "oh, well, I
| now know I should be extra attentive to early dementia symptoms
| in as I get older since ET might occasionally be associated
| with it"
| kbos87 wrote:
| I'm 38 and I've had essential tremor for as long as I can
| remember. For most of my life it wasn't much of a nuisance but
| it's slowly and progressively worsened over the last 5 or so
| years. I won't dare try to pick up a full drinking glass anymore,
| and a forkful of food is unlikely to make it to my mouth without
| jiggling off. Glad to hear that early onset isn't implicated here
| but it's still surprising to me how little is known and how
| quickly it's dismissed whenever I've brought it up with my PCP.
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