Prevalence of tremor and Parkinson's disease

Khatter, Avinash S.; Kurth, Matthias; Brewer, Melanie; Crinnian, Charles T.; Drazkowski, Joseph F.; Flitman, Steven S.; Imke, Susan; Spector, Sidney A.; Wood, Kevin L.; Lieberman, Abraham

doi:10.1016/s1353-8020(96)00027-2

Cited by 23 publications

(34 citation statements)

References 19 publications

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“…In a prevalence study of Parkinson's disease and ET, Khatter et al [6] noted a mild isolated postural hand tremor in 56 of 356 (15.7%) individuals aged 65 years and older who underwent a physical examination; the majority of these (45) were unaware of their tremor. In a physiological study, Elble [4] used triaxial accelerometry to measure the amplitude of postural hand tremor in 100 normal subjects 170 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…When the tremor is severe enough, the individual may be diagnosed as having essential tremor (ET) [4,5]. While it is generally accepted that many normal older adults exhibit some degree of clinically detectible yet normal tremor [4], the prevalence, clinical characteristics, and severity of this tremor, with few exceptions [6], have been the subject of little systematic scrutiny. Further characterization and understanding of this tremor may be of value to practitioners whose patient population is comprised primarily of older adults.…”

Section: Introductionmentioning

confidence: 99%

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Senile Tremor

Louis

Wendt

Ford³

1999

Gerontology

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Background/Setting: It is well recognized that mild tremor is common among older adults, but the prevalence and clinical characteristics of this tremor have not been studied in detail. Objectives: To examine a cohort of normal older adults to: (1) ascertain the prevalence of mild test-detectible tremor; (2) quantify the severity and functional impact of this tremor, and (3) determine whether age, gender and concomitant illness predict the severity of tremor. Participants: 76 normal older adults >55 years of age (mean age = 73.7 years). Design: Healthy older adults were identified in a community-based case-control study of essential tremor in Washington Heights-Inwood, New York. All subjects underwent a medical interview and a videotaped neurological examination. The examination included six tests: arm extension, pouring water, drinking water, using a spoon, finger-to-nose movements, and drawing spirals with each arm. Two neurologists rated the severity of tremor using a 0 to +3 clinical rating scale and a total tremor score (TTS) was calculated (range = 0–36). Forward stepwise linear regression was used to determine the association between TTS and other variables. Results: Virtually all (75 or 98.7%) showed signs of tremor (TTS > 0.5). The mean TTS = 6.3 (range = 0–14.5), corresponding to a tremor that was either mild or intermittent. Twenty-eight of 76 (36.8%) received tremor ratings of +2 (clearly oscillatory tremor of moderate amplitude and usually present) during at least one of the six tests; a tremor rating of +2 was 2.1 times more likely to occur in the nondominant than in the dominant hand. Those who were aged 57–74 years had a lower mean TTS (5.8) than those aged 75–93 (6.8), but this was not significant. Only 2 patients (2.6%) answered ‘yes’ to the question ‘do you have uncontrollable shaking in your hands?’ None was taking medication to treat tremor. Gender, ethnicity, concomitant illness (diabetes, arthritis, heart disease), and medications were not associated with a higher TTS. Conclusion: Mild but test-detectible tremor was present in almost all normal older adults, and in one-third this tremor attained a moderate amplitude during at least one activity. Characterization of this tremor would be of value to practitioners who care for older adults.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Senile Tremor

Louis

Wendt

Ford³

1999

Gerontology

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“…The prevalence increases with age. Estimates of the prevalence in individuals who are in their sixties and seventies have been as high as 20.5% (Khatter et al 1996). As such, ET is one of the most common neurologic diseases.…”

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confidence: 99%

Association between essential tremor and blood lead concentration.

Louis

Jurewicz

Applegate

et al. 2003

Environ Health Perspect

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Lead is a ubiquitous toxicant that causes tremor and cerebellar damage. Essential tremor (ET) is a highly prevalent neurologic disease associated with cerebellar involvement. Although environmental toxicants may play a role in ET etiology and their identification is a critical step in disease prevention, these toxicants have received little attention. Our objective was to test the hypothesis that ET is associated with lead exposure. Therefore, blood lead (BPb) concentrations were measured and a lifetime occupational history was assessed in ET patients and in controls. We frequency matched 100 ET patients and 143 controls on age, sex, and ethnicity. BPb concentrations were analyzed using graphite furnace atomic absorption spectrophotometry. A lifetime occupational history was reviewed by an industrial hygienist. BPb concentrations were higher in ET patients than in controls (mean +/- SD, 3.3 +/- 2.4 and 2.6 +/- 1.6 microg/dL, respectively; median, 2.7 and 2.3 microg/dL; p = 0.038). In a logistic regression model, BPb concentration was associated with diagnosis [control vs. ET patient, odds ratio (OR) per unit increase = 1.21; 95% confidence interval (CI), 1.05-1.39; p = 0.007]. BPb concentration was associated with diagnosis (OR per unit increase = 1.19; 95% CI, 1.03-1.37; p = 0.02) after adjusting for potential confounders. Prevalence of lifetime occupational lead exposure was similar in ET patients and controls. We report an association between BPb concentration and ET. Determining whether this association is due to increased exposure to lead or a difference in lead kinetics in ET patients requires further investigation.

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“…Of these 34 studies, 16 were identified in which: 1) the method of case ascertainment involved either neurological examination of all subjects in a population sample or administration of a screening questionnaire followed by neurological examination, and the sensitivity of the screen was provided, and 2) estimates of prevalence were provided within age strata 5,6,11,12,14,16–26. Of these 16,5,6,11,12,14,16–26 12 used diagnostic criteria for ET that are not ideally suited to epidemiological investigations (e.g., the Consensus Statement of the Movement Disorder Society27) because they do not sufficiently separate ET from other entities such as enhanced physiological tremor, and/or used non-neurologists to assign ET diagnoses, which is not optimal. Four studies remained; these were conducted in Israel,18 Turkey,5,20 and Spain 14.…”

Section: Resultsmentioning

confidence: 99%