Tremor-related quality of life: A comparison of essential tremor vs. Parkinson's disease patients

Abstract

Background Tremor-related quality of life is a multi-dimensional concept that reflects the physical, emotional and other health effects of tremor. Curiously, tremor-related quality of life has never been directly compared in patients with the two major tremor disorders, essential tremor (ET) and Parkinson’s disease (PD). We performed a head-to-head comparison of ET with PD patients. Methods The Quality of Life in Essential Tremor (QUEST) questionnaire was administered to 103 ET and 103 matched PD patients enrolled in a clinical-epidemiological study in New York. Results The QUEST total score and QUEST physical subscore were higher in ET than PD patients (both p<0.05). In relative terms, ET patients reported significantly more impairment than PD patients in multiple areas; PD patients reported more impairment than ET patients in one area (all p≤0.02). In absolute terms, tremor impacted on many aspects of quality of life in both diseases, including physical and psychosocial, and in one-third or more of PD patients, tremor sometimes, frequently or always interfered with numerous physical activities, including writing, using a typewriter/computer, fixing small things, dressing, eating, and holding reading material. Conclusions Tremor is a clinical entity that can have numerous effects on patients. While there were relative differences between the two major tremor disorders, ET and PD, in absolute terms, tremor impacted on several domains of quality of life, from physical to psychosocial, in a large proportion of ET and PD patients. Attempts to judge the efficacy of treatments for tremor, whether pharmacological or surgical, should consider its broad impact.

Essential tremor-Parkinson's disease: A double whammy

“…The psychometric attributes of QUEST in ET patients have been assessed and most are satisfactory [9]. The psychometric attributes of QUEST have also been assessed in PD and are satisfactory [18]. …”

Post-diagnostic lived experiences of individuals with essential tremor

“…It has also been found that ability to perform at work, and during leisure activity, impacts upon levels of depression for individuals with essential tremor [13]. As a result of the overlap in essential tremor and Parkinson's disease, previous research has not only explored the relationship between the two conditions [14] but has also compared quality of life [15]. In particular this comparison identified that individuals with essential tremor experienced more impairment in relation to writing, eating, drinking, embarrassment, and concentration [15] in comparison to individuals with Parkinson's disease.…”

“…As a result of the overlap in essential tremor and Parkinson's disease, previous research has not only explored the relationship between the two conditions [14] but has also compared quality of life [15]. In particular this comparison identified that individuals with essential tremor experienced more impairment in relation to writing, eating, drinking, embarrassment, and concentration [15] in comparison to individuals with Parkinson's disease. In addition, individuals with essential tremor were also found to have higher self-ratings of tremor severity in their arms, and drink alcohol more frequently than they would like, compared to individuals with Parkinson's disease, whereas the latter were noted to have higher levels of speech impairment and higher self-ratings of tremor severity in their legs compared to individuals with essential tremor [15].…”

Perceived embarrassment and caregiver burden in essential tremor caregivers

“…Essential tremor (ET) is a progressive neurological disease that is associated with functional disability (1) and diminished quality of life (2). In addition to tremors, individuals with ET may have other motor and non-motor symptoms (3) including poorer balance (4, 5), cognitive impairment (6, 7), depression (8), and sleep dysregulation (9).…”