Does essential tremor increase risk of cognitive impairment and dementia? Yes

Cosentino, Stephanie; Shih, Ludy C.

doi:10.1016/bs.irn.2022.02.011

Cited by 10 publications

(4 citation statements)

References 126 publications

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“…There are studies that support the notion that ET is associated with higher prevalence of psychiatric disorders (e.g., depression, anxiety) and stress-related disorders [2, 3]. There is also a literature that provides evidence that ET is associated with increased odds and risks for other neurological disorders [4, 5]. Leaving these studies aside, which have largely focused on brain-related disorders, there have been surprisingly few data on the relative prevalence of the full spectrum of medical comorbidities among ET patients.…”

Section: Introductionmentioning

confidence: 99%

Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States

Kapinos¹,

Louis²

2023

Neuroepidemiology

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Introduction: Essential tremor (ET) is the most common tremor disorder, estimated to affect 7 million individuals in the U.S. There is little empirical evidence on comorbidities among this population beyond higher prevalence of brain-related and stress-related disorders. This study aims to examine differences in the prevalence of the 31 Elixhauser comorbidities among ET patients compared to statistically similar control patients. Methods: An extract from Optum’s de-identified Clinformatics® Data Mart Database (CDM) from 2018-2019 of adults aged 40 to 80 years with at least one claim with an ET diagnosis was propensity score matched to controls. Logistic regression was used to generate doubly robust adjusted odds ratios for each of the 31 Elixhauser comorbidities. Results: In these analyses, ET patients had significantly greater adjusted odds of depression, alcohol abuse, and other neurological disorders, as well as chronic pulmonary disease, renal failure, hyperthyroidism, and cardiac arrhythmias relative to controls. They also had lower odds of uncomplicated diabetes, congestive heart failure, metastatic cancer, paralysis, peripheral vascular disease, and fluid and electrolyte disorders. Conclusion: A number of recent studies, including our own, suggest that psychiatric, neurologic and stress-related disorders may be more prevalent among ET patients than controls. Additional differences in the prevalence of a range of medical comorbidities have also been variably reported across studies, suggesting that some combination of these might be more prevalent. Further studies would be of value in sorting through these associations.

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Section: Introductionmentioning

confidence: 99%

Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States

Kapinos¹,

Louis²

2023

Neuroepidemiology

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“…For example, studies have demonstrated that people with ET receive lower scores on standard cognitive tests than same-age healthy controls ( 5 – 7 ). Studies further documented that people diagnosed with ET are at greater risk of developing dementia than their same-age peers ( 8 – 10 ). Moreover, a substantial portion of the elder ET population is affected; a quarter (25.0%) have been identified to have prevalent dementia, ( 8 ) and more than a fifth (20.3%) have been identified to have mild cognitive impairment (MCI) ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Association between cognitive diagnosis and a range of significant life events in an elderly essential tremor cohort: a longitudinal, prospective analysis

Berry¹,

Nguyen²,

Cosentino³

et al. 2023

Front. Neurol.

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BackgroundAlthough essential tremor (ET) patients have greater odds of mild cognitive impairment (MCI) and dementia than age-matched controls, the functional consequences of these enhanced odds are unknown. We examined associations between cognitive diagnosis and the occurrence of near falls, falls, use of a walking aid or a home health aide, non-independent living, or hospitalizations within a prospective, longitudinal study of ET patients.MethodsA total of 131 ET patients (mean baseline age = 76.4 ± 9.4 years) completed a battery of neuropsychological tests and questions about life events and were assigned diagnoses of normal cognition (NC), MCI, or dementia at the baseline and at 18-, 36-, and 54-month follow-ups. Kruskall–Wallis, chi-square, and Mantel–Haenszel tests assessed whether the diagnosis was associated with the occurrence of these life events.ResultsPatients with final diagnoses of dementia were more often reported as living non-independently than NC or MCI patients and more often used walking aids than NC patients, with a p-value of <0.05. Patients with a final MCI or dementia diagnosis more often employed a home health aide than NC patients, with a p-value of <0.05. Moreover, Mantel–Haenzsel tests revealed linear associations between the occurrence of these outcomes and the level of cognitive impairment, with a p-value of <0.001 (i.e., dementia > MCI > NC).ConclusionCognitive diagnosis was associated with reported life events of ET patients, including the use of a mobility aid, employment of a home health aide, and removal from an independent living situation. These data provide rare insights into the important role cognitive decline plays in the experiences of ET patients.

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“…In addition to tremor, ET is associated with cognitive decline [6]. Although ET cases display deficits in executive function and memory that worsen over time [6,7,8], and increased odds and risks of mild cognitive impairment (MCI) and dementia [9], the causes of such declines remain largely unexplored [6]. The identification of risk factors associated with cognitive decline in ET, if modifiable, could lead to target efforts at prevention and, even if not modifiable, would provide useful prognostic information to patients and their families.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Performance as a Function of MAPT Haplotype: A Prospective Longitudinal Study of an Essential Tremor Cohort

Ghanem¹,

Berry²,

Farrell³

et al. 2023

Tremor and Other Hyperkinetic Movements

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Background: Cognitive impairment is a feature of essential tremor (ET). There are no studies of the genetic drivers of this association. We examined whether the microtubuleassociated protein tau (MAPT) H1 haplotype is associated with cognitive performance in ET.Methods: ET cases genotyped for the MAPT H1 and H2 haplotypes completed a battery of neuropsychological tests at baseline and four follow-up evaluations. Chi-square, t-tests, and analyses of covariance examined associations between the presence of the MAPT H1 haplotype, cognitive diagnoses of normal, mild cognitive impairment (MCI), and dementia, and performance in specific cognitive domains. Results:We observed no evidence of cognitive differences as a function of the presence of the MAPT H1 haplotype. Specifically, cases with (n = 57) and without (n = 42) this haplotype did not differ with respect to the prevalence of diagnoses of MCI or dementia, p ≥ 0.87. Moreover, cases with vs without this haplotype did not differ in either the age or point in the disease course at which observed conversions to MCI or dementia occurred, p's ≥ 0.51. Finally, no haplotype-related differences were observed in performance in the cognitive domains of attention, executive function, language, memory, visuospatial or global ability, p's ≥ 0.21, or in changes in performance in these domains across time, p's ≥ 0.08. Discussion:The study in an ET cohort revealed no influence of MAPT haplotypes on cognitive performance. This study serves as a valuable foundation for future studies to expand our understanding of the genetic drivers of cognitive impairment in ET. HighlightsThis study found no evidence of cognitive differences between individuals with and without the MAPT H1 haplotype. Our work provides a valuable foundation for future work to expand our knowledge of the genetic drivers of cognitive impairment in ET.

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Does essential tremor increase risk of cognitive impairment and dementia? Yes

Cited by 10 publications

References 126 publications

Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States

Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States

Association between cognitive diagnosis and a range of significant life events in an elderly essential tremor cohort: a longitudinal, prospective analysis

Cognitive Performance as a Function of MAPT Haplotype: A Prospective Longitudinal Study of an Essential Tremor Cohort

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