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The NEDICES Study: Recent Advances in the Understanding of the Epidemiology of Essential Tremor Cover

The NEDICES Study: Recent Advances in the Understanding of the Epidemiology of Essential Tremor

Open Access
|Jun 2012

Figures & Tables

Table 1.

Main Results Regarding Essential Tremor in NEDICES Study

ResultsComments
PrevalenceOverall: 4.8% (95% CI = 4.2–5.4).34% of the ET cases had an affected relative and 79.7% were detected through the NEDICES study and had not been diagnosed by a physician prior to the NEDICES study assessment.
Men: 4.6% (95% CI = 3.7–5.4).
Women: 5.0% (95% CI = 4.2–5.8).
Incidence616 per 100,000 person-years (95% CI = 447–784)77% of incident cases were detected through the NEDICES study and had not been diagnosed by a physician prior to the NEDICES study assessment.
MortalityUnadjusted RR = 1.59, 95% CI = 1.11–2.27, p = 0.01).ET may be a disease not only of increased morbidity but of increased mortality as well.
Adjusted RR = 1.45, (95% CI = 1.01–2.08, p = 0.04).
FrailtyA 20-item frailty score, which assessed comorbid conditions, number of medications, and functional activity was higher in ET cases than in controls (8.6±5.2 vs. 6.8±4.6, p<0.001)This study suggests that there may be an additional frailty syndrome in ET that is above and beyond what has been described previously.
Subjective well-beingThe Philadelphia Geriatric Center Morale Scale score was lower in ET cases than controls (9.41±3.21 vs. 10.39±2.92, p<0.001)Morale may be lower in ET cases than in matched controls.
Self-reported depressive symptomsPrevalent ET cases were twice more likely than controls to report depression and three times more likely to be taking antidepressant medications. In prospective analyses, baseline self-reported depression and, perhaps, baseline use of antidepressant medication were associated with incident ET.ET seems to be associated with depressive symptoms.
Cognitive functioningET cases performed less well than controls especially on tests of global cognitive performance and frontal executive function. Lower cognitive test scores were associated with more reported functional difficulty. During the 3-year follow-up period, baseline cognitive test scores declined at a rate that was seven-times faster in ET cases than controlsA frontosubcortical-type dysfunction occurs in some ET patients. Lower cognitive test scores in ET, rather than being clinically inconsequential, seem to have a clinical-functional correlate.
MCIET cases with tremor onset after age 65 years were 57% more likely to have mild cognitive impairment than controls (OR = 1.57, 95% CI = 1.03–2.38, p = 0.03).Elderly-onset ET may be associated with MCI
Prevalent dementiaET cases with tremor onset after age 65 were 70% more likely to be demented than were controls (OR = 1.70, 95% CI = 1.04–2.76, p = 0.03).Elderly-onset ET may be associated with dementia
Incident dementiaET cases with tremor onset after age 65 years were twice as likely to develop incident dementia than were controls (RR = 1.98, 95% CI = 1.14 -3.45, p = 0.01).Elderly-onset ET may be associated with incident dementia
incident Parkinson's diseaseET cases were four times more likely than controls to develop incident PD during prospective follow-up.The link between ET and incident PD has for the first time been formally quantified
Hearing impairmentIn an adjusted logistic regression analysis participants who reported hearing impairment were 30% more likely to suffer from ET than were controls (OR = 1.3; 95% CI = 1.01–1.7, p = 0.04).ET may be associated with hearing impairment.
SmokingSmokers were nearly half as likely to have ET as were never smokers (adjusted OR = 0.58, p = 0.004). In addition, baseline heavy cigarette smoking was also associated with a lower risk of incident ET (adjusted RR = 0.29, p = 0.03)Smoking may be associated with decreased the risk of developing ET
EthanolIn an adjusted Cox model, the highest baseline drink-year quartile doubled the risk of incident ET (RR = 2.29, p = 0.018)Higher levels of chronic ethanol consumption may be associated with increased the risk of developing ET

Abbreviations: CI, confidence interval; ET, essential tremor; MCI, mild cognitive impairment; NEDICES, Neurological Disorders of Central Spain; OR, odds ratio; PD, Parkinson's disease; RR, relative risk.

DOI: https://doi.org/10.5334/tohm.117 | Journal eISSN: 2160-8288
Language: English
Submitted on: Oct 15, 2011
Accepted on: Nov 10, 2011
Published on: Jun 15, 2012
Published by: Columbia University Libraries/Information Services
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2012 Juan Pablo Romero, Julián Benito-León, Félix Bermejo-Pareja, published by Columbia University Libraries/Information Services
This work is licensed under the Creative Commons License.