title: Self-rated health and risk of incident essential tremor: A prospective, population-based study (NEDICES).
abstract: BACKGROUND
  Essential tremor (ET), a highly-prevalent, progressive, aging-associated neurological disease, poses a significant public health challenge. Aside from its associated motor features, the disease affects cognition in some patients, mood, and morale, and has been associated with increased risk of mortality in the elderly. Studies have not investigated the relationship between self-rated health and risk of ET. We determined whether baseline poor self-rated health was associated with increased risk of incident ET.
  
  
  METHODS
  In this prospective, population-based study of people ≥65 years of age, subjects were evaluated at baseline and 3 years later. At baseline, subjects were asked to rate their health using a single-item health question. Hazard ratios (HR) of ET according to baseline self-rated health (very good, good, fair, poor, and very poor) were estimated with Cox models.
  
  
  RESULTS
  The 3853 subjects had a median follow-up duration of 3.2 years. There were 82 incident ET cases. Compared to subjects who rated their health as good or very good, the risk of ET was increased for subjects who rated their health as fair (HR = 1.69, p = 0.03), and for subjects who rated their health as poor or very poor (HR = 2.12, p = 0.02). In a fully adjusted model, the risk remained increased for subjects who rated their health as poor or very poor (HR = 2.34, p = 0.01).
  
  
  CONCLUSIONS
  Subjects rating their health as poor/very poor at baseline were at increased risk of incident ET at follow-up. Premotor and/or early motor symptoms of ET could negatively influence self-perceptions of health status.
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Complutense University, Madrid, Spain. Electronic address: jbenitol67@gmail.com.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.affiliation: Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Complutense University, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo-Galende
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Labiano-Fontcuberta
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Complutense University, Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D020329:Essential Tremor / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Clinical; Disease mechanisms; Epidemiology; Essential tremor; Population-based; Self-rated health