What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders

Adeel Zubair, Tess E.K. Cersonsky, Sarah Kellner, Edward D. Huey, Stephanie Cosentino, Elan D. Louis

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. Methods: In a longitudinal, prospective study of 141 elders with ET, we used Cox proportional-hazards models to estimate hazard ratios (HRs) for death. Results: The mean baseline age was 81.1 ± 8.8 years. During the follow-up interval, 27 (19.1%) died. Average time from baseline to death was 12.3 ± 8.7 months (range = 0.3–31.2). In univariate Cox regression models, older age (HR = 1.16, p < 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p < 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. Conclusions: This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.

Original languageEnglish (US)
Article number1077
JournalFrontiers in Neurology
StatePublished - Dec 7 2018
Externally publishedYes


  • cognitive aging
  • cognitive impairment
  • dementia
  • depression
  • essential tremor
  • mortality

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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