Essential tremor in the elderly

2000 ◽  
pp. 80-97
Author(s):  
Rajesh Pahwa ◽  
William C. Koller
Keyword(s):  
Essential Tremor ◽  
The Elderly

Flunarizine and essential tremor in the elderly

1996 ◽  
Vol 22 ◽  
pp. 73-77 ◽  
Author(s):  
I. Vecchio ◽  
L. Rampello ◽  
C. Tornali ◽  
M. Malaguarnera ◽  
R. Raffaele
Keyword(s):  
Essential Tremor ◽  
The Elderly

scholarly journals White Matter Hyperintensities Are Associated With Severity of Essential Tremor in the Elderly

2021 ◽  
Vol 12 ◽  
Author(s):  
Jos S. Becktepe ◽  
Johannes Busse ◽  
Ulf Jensen-Kondering ◽  
Inken Toedt ◽  
Stephan Wolff ◽  
...  
Keyword(s):  
White Matter ◽  
Essential Tremor ◽  
White Matter Hyperintensities ◽  
Disease Duration ◽  
Multiple Linear Regression Model ◽  
The Elderly ◽  
Significant Negative Correlation ◽  
Common Finding ◽  
Healthy Controls ◽  
The Impact

Background: Essential tremor (ET) occurs with steeply increasing prevalence in the elderly, and apart from disease duration, age is independently associated with an increase of tremor amplitude and a decrease of frequency. White matter hyperintensities (WMHs) are a common finding in the elderly, and their role in the pathophysiology of ET is unknown. The aims of this study were to examine whether ET patients differ in their total or region-specific WMH volumes from healthy controls and to determine the impact of WMH on tremor characteristics.Methods: A total of 47 elderly ET patients with a mean age of 72 years and 39 age-matched healthy controls underwent a thorough clinical assessment and 3T MRI. Total WMH volumes were derived from T2-weighted fluid-attenuated inversion recovery (FLAIR) MR images. Additionally, region of interest-based WMH volumes for the Johns Hopkins University (JHU) white matter tracts and labels were calculated, and WMHs were assessed semiquantitatively using the Fazekas scale.Results: Essential tremor patients and healthy controls did not differ in their total or tract-specific WMH volumes or Fazekas scores. However, WMH volume was significantly positively correlated with tremor severity on the TETRAS scale, and there was a significant negative correlation with the mean accelerometric tremor frequency. In a multiple linear regression model including disease duration, age, and age-adjusted total WMH volume, only the WMH volume significantly predicted tremor severity, while age and disease duration were not significant.Conclusion: We found evidence for a direct association between WMH volume and tremor severity. If confirmed by larger studies, our findings could explain the well-known relation between age and tremor severity.

scholarly journals Essential Tremor in the Elderly and Risk for Dementia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Holly A. Shill ◽  
Joseph G. Hentz ◽  
Sandra A. Jacobson ◽  
Christine Belden ◽  
Marwan N. Sabbagh ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Neurodegenerative Disorders ◽  
The Elderly ◽  
Hazard Ratio ◽  
Older Age ◽  
Study Entry ◽  
Increased Risk ◽  
Neuropsychological Assessments

The objective is to examine the risk of dementia in subjects with essential tremor (ET) involved in the Arizona Study of Aging and Neurodegenerative Disorders. All subjects were free of a neurodegenerative diagnosis at baseline and had annual motor, general neurological, and neuropsychological assessments. Subjects with ET were compared with controls for the risk of dementia. There were 83 subjects with ET and 424 subjects without tremor. Mean age at study entry was 80±5.9 for ET and 76±8.5 for controls. Median tremor duration was 5.2 years at study entry. Followup was a median of 5.4 years (range 0.9 to 12.1). The hazard ratio for the association between ET and dementia was 0.79 (95% CI 0.33 to 1.85). The hazard ratio for the association between tremor onset at age 65 or over, versus onset before age 65, was 2.1 (95% CI 0.24 to 18) and the hazard ratio for the association between tremor duration greater than 5 years, versus less than 5 years, was 0.46 (95% CI 0.08 to 2.6). We conclude that all elderly ET was not associated with an increased risk of dementia but that a subset of subjects with older age onset/shorter duration tremor may be at higher risk.

Essential tremor not just a tremor (review)

2021 ◽  
Vol 1 (223) ◽  
pp. 39-43
Author(s):  
Guzel Shiderova ◽  
◽  
Altynay Karimova ◽  
Gulnaz Kaishibayeva ◽  
Gulmira Amrayeva ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Essential Tremor ◽  
Web Of Science ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Motor Symptoms ◽  
The Past ◽  
Search Terms ◽  
Anxiety Depression ◽  
Non Motor Symptoms

Essential tremor is one of the most common movement disorders. The nature of this disease is not fully understood. It was believed that this pathology manifests itself only by tremor, and symptoms such as depression, anxiety and apathy in patients with essential tremor can only be regarded as a reaction to the presence of tremor. Cognitive impairment is a concomitant pathology that can occur in the elderly, which accounts for a more frequent onset of the disease. But is it really so Purpose of the study. To study the literature data to identify the presence in patients with essential tremor of such signs that can be attributed to the group of "non-motor" symptoms. Material and methods. In order to study the literature data, a search was carried out in the Web of Science, PubMed databases. During the search, all articles published since 2000 were examined and the following terms were used in combination with "essential tremor": "non-motor symptoms", "anxiety", "depression", "apathy", "cognitive impairment", "sleep disorders", "hearing impairment", "hyposmia". The main search terms were studies based on the study of patients with essential tremor: meta-analyzes, original studies, retrospective and cohort studies. Results and discussion. It can be unambiguously argued that symptoms such as anxiety, depression, apathy and cognitive, hearing and smell dysfunctions are characterised to the patients with essential tremor. The first three manifestations were attributed to the response to the presence of tremor. And cognitive functions, hearing and smell dysfunctions was considered a concomitant pathology, which occurs quite often in old age, which accounts for a more frequent onset of the disease. But in reality, everything is not so simple. The literature data, which began to appear over the past 20 years, make it clear that the previously mentioned clinical manifestations may well be regarded as "non-motor" symptoms of essential tremor. Conclusion. Nowadays neurologists are increasingly faced with the problem of differential diagnosis of essential tremor. Despite the fact that everything was very simple and clear on the diagnosis of this disease, in recent years more and more data have appeared in favor of the fact that essential tremor is a heterogeneous disease that manifests not only by tremor. But this is also a disease, which, due to its heterogeneity of pathophysiology, can give great variability in the clinical picture. Keywords: essential tremor, nonmotor symptoms, anxiety, depression, cognitive impairnment, dementia.

scholarly journals Zonisamide for the Management of Essential Tremor: An Illustrative Case Report on Long-Term Effectiveness

2017 ◽  
Vol 64 (1) ◽  
pp. 11-14
Author(s):  
Jack Chen
Keyword(s):  
Case Report ◽  
Essential Tremor ◽  
The Elderly ◽  
Maximum Tolerated Dose ◽  
Illustrative Case ◽  
Modest Improvement ◽  
Beneficial Effects ◽  
Clinically Significant

Essential tremor, a common adult pathologic tremor disorder, is characterized by action tremors. Mainstays of treatment include gabapentin, primidone, and propranolol. However, many patients obtain insufficient benefit or do not tolerate these medications (especially the elderly). Short-term studies demonstrate that zonisamide may be effective for essential tremor; however, long-term data are lacking. This is a case report of an 83-year-old, right-handed man with essential tremor of the upper extremities and head who previously failed several pharmacological treatments (defined as obtaining inadequate benefit from maximum tolerated dose) with gabapentin, nadalol, propranolol, and primidone and was initiated on zonisamide monotherapy. Long-term zonisamide therapy (200 mg daily) was well tolerated in this elderly patient and associated with clinically significant improvement of upper extremity tremor and clinically modest improvement in head tremor. The beneficial effects and tolerability were sustained over nearly 28 months of follow-up treatment.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

The effect of dental geriatric curricula on attitudes toward the elderly

1988 ◽  
Vol 52 (9) ◽  
pp. 516-518 ◽  
Author(s):  
J Mann ◽  
TJ Bomberg ◽  
JM Holtzman ◽  
DB Berkey
Keyword(s):  
The Elderly

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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