Mild Tremor Tied to Cognitive Decline in Seniors

TOPLINEEven mild non-pathological tremor is associated with lower cognitive performance in community-dwelling adults aged 65 years and older. For each one-point increase in tremor severity, cognitive scores declined by more than half a point.METHODOLOGYA cross-sectional analysis of 894 participants from a population-based study in Germany examined whether mild action tremor in older people is associated with cognitive function.Participants aged 65 years and older (mean age, 75 years; 49.1% female) underwent cognitive assessment using the Telephone Interview for Cognitive Status-modified (TICS-m) and tremor evaluation via Archimedes spiral drawing rated on a 0-10 scale.Researchers assessed tremor severity using the Archimedes Spiral Rating (ASR) scale, with higher scores indicating more severe tremor.Multiple regression analysis adjusted for age, sex, Parkinson score, frailty status, sleep duration, physical activity, and history of stroke assessed the independent effect of tremor on cognition.TAKEAWAYEach one-point increase in ASR was associated with a 0.63-point decrease in TICS-m score (β, −0.63; P = .001) after adjusting for multiple covariates.The association remained significant across sensitivity analyses excluding participants with stroke history (β, −0.59; P = .004), those with Parkinson scores greater than 21 (β, −0.70; P = .002), and those with ASR greater than 3 (β, −1.08; P < .001).Other significant predictors of lower cognitive performance included older age (β, −0.19 per year), male sex (β, −1.99), frailty (beta, −1.16), and higher Parkinson score (β, −0.05 per point; P < .001for all).Beta-blocker use did not significantly modify the tremor-cognition association, and adding beta-blockers to the model did not substantially change the tremor effect (β, −0.64; P = .0014).IN PRACTICE"One of the possible interpretations is that aging-associated brain changes are the common cause for tremor and cognitive decline," the authors of the study wrote."We conclude that the severity of mild action tremor within the range of the mean plus/minus one standard deviation of the ASR in this age group is associated with decreased cognitive performance assessed using the TICS-m," they added.SOURCEThe study was led by Gregor Kuhlenbaumer, Department of Neurology, Kiel University, Kiel, Germany. It was published online on August 11 in Journal of Neurology.LIMITATIONSThe study lacked data on longitudinal assessment of ASR. Tremor assessment relied on a single Archimedes spiral drawing rather than comprehensive tremor evaluation, and the study excluded individuals with missing data on key variables, who were likely to have severe cognitive impairment.DISCLOSURESThe study was supported by grants from the German Federal Ministry of Research, Technology and Space (BMFTR) and by the State of Bavaria. Several authors are employees of Helmholtz Zentrum München, which received funding for the KORA study. One author reported research grants from BMFTR and author honoraria from medical publishers and foundations. Additional author disclosures are reported in the original article.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.