Balance confidence and falls in nondemented essential tremor patients: the role of cognition.
OBJECTIVE
To examine (1) the effect of cognitive ability on balance confidence and falls, (2) the relationship of balance confidence and falls with quantitative measures of gait, and (3) measures that predict falls, in people with essential tremor (ET).


METHODS
Cross-sectional study.


METHODS
General community.


METHODS
People with ET (n=132) and control subjects (n=48). People with ET were divided into 2 groups based on the median score on the Modified Mini-Mental State Examination: those with lower cognitive test scores (ET-LCS) and those with higher cognitive test scores (ET-HCS).


METHODS
Not applicable.


METHODS
Six-item Activities of Balance Confidence (ABC-6) Scale and falls in the previous year.


RESULTS
Participants with ET-LCS had lower ABC-6 scores and a greater number of falls than those with ET-HCS (P<.05 for all measures) or control subjects (P<.01 for all measures). Quantitative gait measures were significantly correlated with ABC-6 score and falls. Gait speed (P<.007) and ABC-6 score (P<.02) were significant predictors of falls. Receiver operating characteristic curve analysis revealed that gait speed <0.9m/s and ABC-6 score <51% were associated with moderate sensitivity and specificity in identifying fallers.


CONCLUSIONS
People with ET-LCS have impaired gait and report lower balance confidence and a higher number of falls than their counterparts (ET-HCS) and than control subjects. We have identified assessments that are easily administered (gait speed, ABC-6 Scale) and are associated with falls in ET.
Department of Rehabilitation & Regenerative Medicine (Program in Physical Therapy), Columbia University, New York, NY; G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: akr7@cumc.columbia.edu.
Ashwini K
AK
Rao
G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY.
Arthur
A
Gilman
Department of Neurology, G.H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Elan D
ED
Louis
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003430:Cross-Sectional Studies; D020329:Essential Tremor / Q000503:physiopathology / Q000523:psychology*; D005684:Gait; D006801:Humans; D004856:Postural Balance; D012372:ROC Curve; D012189:Retrospective Studies; D020377:Self Efficacy
Accidental falls; Balance confidence; Cognition; Essential tremor; Gait; Rehabilitation