Self-reported physical activity in essential tremor: Relationship with tremor, balance, and cognitive function

Abstract

Background Physical inactivity may be the result of medical comorbidities. Inactivity itself may also lead to important health consequences, especially in older patients. Essential tremor (ET) patients may have a variety of physical and cognitive problems that could detrimentally impact on level of physical activity. Yet, to our knowledge, there have been no studies of physical activity in these patients. Methods Self-reported physical activity was assessed using the Physical Activity Scale for the Elderly (PASE) in 100 ET cases (mean age 80.5 years) enrolled in a clinical study. Additional clinical measures were the total tremor score, Montreal Cognitive Assessment (MOCA) score and number of steps taken off of the straight line during tandem gait (a measure of balance). Results Lower PASE score was associated with older age, more tandem gait difficulty, higher total tremor score and lower MOCA score (all p<0.05). In a linear regression model that included total tremor score, MOCA score, number of steps off of the straight line during tandem gait, and age, higher total tremor score (p = 0.046) and more steps off of the straight line during tandem gait (p = 0.014) were independently associated with reductions in physical activity. Conclusions Several of the motor features of ET (tremor and imbalance) are independently associated with reductions in level of physical activity.

Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

“…Of these, only one paper 9 reported that duration of ET, in addition to age, was correlated with balance impairments. In contrast, seven papers 6,7,8,11,22,41,42 did not find a significant correlation of balance impairment with the duration of ET, and two papers 10,20 did not report on this relationship.…”

“…11 Lower balance confidence, and falls were associated with reduction in self-reported physical activity. 42 These results indicate that balance impairments not only limit functional activity, but may lead to reduced physical activity. The functional importance of balance impairment was highlighted in a recent study, which reported that impairment on the tandem walk test was a significant predictor of mortality in ET patients.…”

“…Our initial search through PubMed yielded 42 articles. An additional 12 articles were identified from other sources (CINAHL, Embase, and Google Scholar).…”

Physical Activity as a Predictor of Cognitive Decline in an Elderly Essential Tremor Cohort: A Prospective, Longitudinal Study

“…Besides older age, additional variables have yet to be identified as predictors of cognitive decline in ET (12). In one cross-sectional study of participants with ET, an association was identified between lower levels of physical activity and poorer performance on the Montreal Cognitive Assessment (MOCA), a common measure of global cognition (13). Similarly, lower physical activity has been identified as a longitudinal predictor of conversion to MCI (14) and dementia (15)(16)(17)(18) in the general population.…”

Evaluating Mild Cognitive Impairment in Essential Tremor: How Many and Which Neuropsychological Tests?

“…Among the latter are cognitive impairments (Benito-Leon & Louis, 2013;Janicki, Cosentino, & Louis, 2013;Louis, 2010;Louis & Rao, 2014b;Mameli et al, 2013;Sinoff & Badarny, 2014), such as reductions in attention, executive function, visuospatial processing, and memory (Gasparini et al, 2001;Janicki et al, 2013;Kim et al, 2009;Lombardi, Woolston, Roberts, & Gross, 2001;Tröster et al, 2002); and increased risk of mild cognitive impairment (MCI) and dementia (Benito-León, Louis, Bermejo-Pareja, & NEDICES Study Group, 2006a, 2006b; Benito-León, Louis, Mitchell, & Bermejo-Pareja, 2011;Bermejo-Pareja, Louis, Benito-León, & NEDICES Study Group, 2007;Louis, Benito-León, Vega-Quiroga, Bermejo-Pareja, & NEDICES Study Group, 2010; Correspondence and reprint requests to: Stephanie Cosentino; Columbia University Medical Center, 630 West 168th Street; P&S Mailbox 16; NY, NY 10032; E-mail: sc2460@cumc.columbia.edu Thawani, Schupf, & Louis, 2009), deficits which are reflected in functional imaging studies, with abberant network connectivity observed to be associated with tremor features and cognitive dysfuncton (Benito-León et al, 2015). Cognitive dysfunction that occurs in ET, even when mild, is accompanied by a range of functional consequences (Louis et al, 2010(Louis et al, , 2016(Louis et al, , 2017Rao, Gillman, & Louis, 2014;Rao, Uddin, Gillman, & Louis, 2013), thereby highlighting its importance.…”