Philadelphia Geriatric Morale Scale in essential tremor: A population-based study in three Spanish communities

Authors

  • Elan D. Louis MD, MSc,

    Corresponding author
    1. G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    3. Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
    • Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032
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  • Julián Benito-León MD, PhD,

    1. Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
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  • Félix Bermejo-Pareja MD, PhD

    1. Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
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  • Members of the Neurological Disorders in Central Spain (NEDICES) Study Group are listed as an Appendix.

Abstract

Essential tremor (ET) is associated with both functional disability and depression. Each could contribute to a poor sense of well-being and low morale. We hypothesized that morale would be lower in ET cases than controls. Using a population-based, cross-sectional design, morale was assessed in 187 ET cases and 561 matched controls living in three communities in central Spain using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0 [low morale]–17), which included three-dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging. The PGCMS score was lower in ET cases than controls (9.41 ± 3.21 vs. 10.39 ± 2.92, P < 0.001), as were the Agitation subscore (3.17 ± 1.71 vs. 3.78 ± 1.67, P< 0.001) and Lonely Dissatisfaction subscore (3.75 ± 1.34 vs. 4.02 ± 1.24, P < 0.05). Nearly one-half of the ET cases were classified as having low morale compared with only one-third of controls (P = 0.006). In a linear regression analysis adjusting for demographic factors and multiple comorbid conditions, ET cases had a lower log PGCMS score than controls (P < 0.001). Exclusion of participants on antidepressant medication did not change the results. Our results indicate that morale is significantly lower in community-dwelling ET cases than in matched controls. This lower morale could in part be a proxy for mild, untreated depression. It therefore seems important to detect and then possibly treat this problem to improve the psychological well-being of patients with this disease. © 2008 Movement Disorder Society

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