Research Article

Regional and racial differences in the prevalence of physician-diagnosed essential tremor in the United States†

  1. Elan D. Louis MD, MS1,2,*,
  2. Linda P. Fried MD, MPH3,
  3. Annette L. Fitzpatrick PhD4,
  4. William T. Longstreth Jr. MD4,5,
  5. Anne B. Newman MD, MPH6

Article first published online: 5 MAY 2003

DOI: 10.1002/mds.10492

Issue

Movement Disorders

Movement Disorders

Volume 18, Issue 9, pages 1035–1040, September 2003

Additional Information

How to Cite

Louis, E. D., Fried, L. P., Fitzpatrick, A. L., Longstreth, W. T. and Newman, A. B. (2003), Regional and racial differences in the prevalence of physician-diagnosed essential tremor in the United States. Mov. Disord., 18: 1035–1040. doi: 10.1002/mds.10492

Author Information

  1. 1

    The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA

  2. 2

    Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA

  3. 3

    The Welch Center, Johns Hopkins University, Baltimore, Maryland, USA

  4. 4

    Department of Epidemiology, University of Washington, Seattle, Washington, USA

  5. 5

    Department of Neurology, University of Washington, Seattle, Washington, USA

  6. 6

    Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

*Unit 198, Neurological Institute, 710 West 168th Street, New York, NY, 10032

  1. †

    See Acknowledgments for a full list of Cardiovascular Health Study participants.

Publication History

  1. Issue published online: 2 SEP 2003
  2. Article first published online: 5 MAY 2003
  3. Manuscript Accepted: 27 FEB 2003
  4. Manuscript Revised: 5 FEB 2003
  5. Manuscript Received: 26 NOV 2002

Funded by

  • National Heart, Lung, and Blood Institute. Grant Numbers: N01-HC-85079, N01-HC-85086, N01-HC-35129, N01-HC-15103

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Keywords:

  • essential tremor;
  • epidemiology;
  • ethnicity;
  • prevalence

Abstract

For reasons that are unclear, prevalence estimates of essential tremor (ET) differ considerably across the United States. Separate communities have never been sampled within the framework of the same study to substantiate these differences. We estimated the prevalence of physician-diagnosed ET in the elderly in four communities in the United States in whom the same screening questions were used, and examined whether this prevalence differed between Caucasians and African Americans. The Cardiovascular Health Study recruited a sample of Medicare beneficiaries ≥65 years of age from four communities in different regions of the United States. In 1998 to 1999, 3,494 participants (mean age, 80.0 years; range, 70–103 years) answered a 12-question screen for ET, including the question, “has a doctor diagnosed you as having familial tremor or benign essential tremor?” Fifty-four participants reported that a doctor had diagnosed them as having ET (1.5%; 95% confidence interval, [CI], 1.1–2.0%). Prevalence was similar across the four communities (1.1–2.0%). A larger proportion of Caucasians than African Americans reported a diagnosis of ET (1.7% vs. 0.4%; odds ratio = 4.9; 95% CI, 1.2–20.2; P = 0.028). In a logistic regression analysis, physician-diagnosed ET was associated with Caucasian ethnicity (P = 0.038) but not with age, gender, education, mental status or depression scores, income, smoking status, or alcohol consumption. When a standardized screening question was used, the proportion of participants with physician-diagnosed ET was similar across four communities, suggesting that the prevalence of this condition may be less variable than is often reported. Caucasians were five times more likely to have physician-diagnosed ET than were African Americans. This study does not provide an explanation for this difference, which deserves further study. © 2003 Movement Disorder Society

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