Faster rate of cognitive decline in essential tremor cases than controls: a prospective study.
BACKGROUND
Mild cognitive deficits have been reported in essential tremor (ET). However, these cognitive deficits have been assessed in cross-sectional rather than longitudinal analyses.


OBJECTIVE
To determine whether decline in cognitive test scores occurs at a faster rate in ET cases than controls.


METHODS
In a population-based study of older people (≥ 65 years) in central Spain (Neurological Disorders in Central Spain, NEDICES), non-demented ET cases and controls were followed prospectively. Participants with baseline or incident Parkinson's disease or dementia were excluded as were participants who developed incident ET. At baseline (1994-1995) and at follow-up (1997-1998), a 37-item version of the mini-mental state examination (37-MMSE) was administered.


RESULTS
A total of 2319 participants (72.4 ± 5.8 years) included 135 prevalent ET cases and 2184 controls. At baseline, the mean 37-MMSE in cases was 28.8 ± 5.8 vs. 30.2 ± 4.8 in controls (P = 0.02). During the 3-year follow-up period, the 37-MMSE declined by 0.70 ± 3.2 points in cases vs. 0.11 ± 3.8 points in controls (P = 0.03). In analyses that adjusted for age, education, and other potential confounders, the case-control difference remained robust.


CONCLUSIONS
In this population-based, prospective study of non-demented elders, baseline cognitive test scores were lower in ET cases than controls; moreover, during the 3-year follow-up period, these scores declined at a rate that was seven-times faster in ET cases. This study provides evidence that cognitive deficits in ET are not static, and they appear to be progressing at a faster rate than in elders without this disease.
Louis
E D
ED
GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA. EDL2@columbia.edu
Benito-León
J
J
Vega-Quiroga
S
S
Bermejo-Pareja
F
F
D000368:Aged; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D020329:Essential Tremor / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies