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Tremor in the elderly


Psychologie & NeuroPsychiatrie du vieillissement. Volume 6, Number 3, 199-208, Septembre 2008, Synthèse

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Author(s) : Charles Pierre Jedynak, Evelyne Diarra, Marc Verny

Summary : The various causes of tremor are considered by order of prevalence in the elderly. 1) Essential tremor occurs in 5% of the population beyond 65 years of age. It is characterized by a tremor accompanying muscle activity, and interesting, when complete, the two upper limbs, the head and the voice, with variable degree of severity. Its progression is very slow. The diagnostic criteria are only clinical, but require ruling out iatrogenic and metabolic causes. 2) Tremor in Parkinson’s disease is opposed point by point to essential tremor. However, confusion may occur due to some intermediate clinical situations. In these cases, pharmacology or DaTSCAN© data can help to distinguish between the two conditions. 3) Other causes are considered, giving the priority to practical and therapeutic aspects. The psychological consequences of tremor should be taken into account to improve the quality of life of patients with tremor. Terms which stigmatize, such as senile tremor, or terms which minimize the relational and social consequences of tremor, such as benign tremor, should be discarded.

Keywords : essential tremor, Parkinson disease, iatrogenic tremor, metabolic tremor, dystonia, orthostatic tremor, pharmacology, elderly

 

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