[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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