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From the G.H. Sergievsky Center and Department of Neurology, College of Physicians and Surgeons (E.D.L., R.O.), and Department of Epidemiology, Mailman School of Public Health (E.D.L., R.O.), Columbia University, New York, NY; the Department of Neurology (J.B.-L., F.B.-P.), University Hospital "12 de Octubre", Madrid, Spain; and the Epidemiology of Brain Disorders Research Department (R.O.), New York State Psychiatric Institute, New York.
Address correspondence and reprint requests to Dr. Elan Louis, Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032 EDL2{at}columbia.edu
Background: Although data are sparse, people with essential tremor (ET) are usually assumed to have mortality rates similar to those in the general population. Because ET is common, particularly among older adults, an influence of ET on the life span would have important public health implications. The authors compared the risks of mortality in patients with ET and control subjects without ET.
Methods: A prospective, population-based design was used to compare the risk of mortality in participants with ET vs controls in three communities in central Spain. Participants were evaluated at baseline (1994 to 1995) and at follow-up 3 years later (1997 to 1998). The relative risk (RR) of mortality (ET vs controls) was estimated using Cox proportional hazards models that excluded participants with Parkinson disease or dementia.
Results: Mean baseline age was 73.5 ± 6.4 years. There were 33 (16.4%) deaths among 201 ET cases and 465 (13.9%) among 3,337 controls. In an unadjusted Cox model, risk of mortality was increased in ET (RR = 1.59, 95% CI = 1.11 to 2.27, p = 0.01). In a Cox model that adjusted for baseline age, gender, educational category, current ethanol drinking, use of antidepressant medication, and community, RR = 1.45, 95% CI = 1.01 to 2.08, p = 0.04. In an adjusted Cox model restricted to persons with longer (>3 years) follow-up, RR = 4.69 (95% CI = 2.18 to 10.07, p = 0.001).
Conclusions: In this longitudinal, prospective study, the risk of mortality was increased in essential tremor. Additional studies of incident cases are needed to confirm these results.
Abbreviations: DSM = Diagnostic and Statistical Manual of Mental Disorders; ET = essential tremor; NEDICES = Neurological Disorders in Central Spain; PD = Parkinson disease; RR = relative risk.
*The other members of the Neurological Disorders in Central Spain (NEDICES) Study Group are listed in the appendix.
NEDICES was supported by the Spanish Health Research Agency (FIS 93/0773 and 96/1993) and the Spanish Office of Science and Technology. Dr. Louis is supported by R01 NS042859 and R01 NS039422 from NIH, Bethesda, MD.
Disclosure: The authors report no conflicts of interest.
Received February 2, 2007. Accepted in final form May 23, 2007.
This article has been cited by other articles:
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  E. D. Louis, J. Benito-Leon, F. Bermejo-Pareja, and On behalf of the Neurological Disorders in Central Population-based prospective study of cigarette smoking and risk of incident essential tremor Neurology, May 6, 2008; 70(19): 1682 - 1687. [Abstract] [Full Text] [PDF]
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 Is Mortality Increased with Essential Tremor? Journal Watch Neurology, March 11, 2008; 2008(311): 3 - 3. [Full Text]
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