Rate of progression from mild cognitive impairment to dementia in an essential tremor cohort: A prospective,longitudinal study |
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| Affiliation: | 1. Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA;2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA;3. Taub Institute for Research on Alzheimer''s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA;4. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA;5. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA;6. Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA;7. Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA;1. Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA;2. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA;3. Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA;4. Taub Institute for Research on Alzheimer''s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA;5. Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA;6. G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA;7. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA;8. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA;9. Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA;1. Cognitive Neuroscience Division, Department of Neurology, Gertrude H. Sergievsky Center, NY, USA;2. Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA;3. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA;4. Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA;5. Taub Institute for Research on Alzheimer''s Disease and the Aging Brain, Columbia University Medical Center, NY, USA |
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| Abstract: | BackgroundEssential tremor (ET), among the most common neurological diseases, is associated with cognitive dysfunction. Yet, nearly all knowledge of ET-related cognitive impairment is static and cross-sectional (e.g., prevalence), with virtually no dynamic information (i.e., course and progression, conversion rates, and clinical outcomes).ObjectivesTo quantify the rate of progression from mild cognitive impairment (MCI) to dementia in a cohort of elderly ET cases.Methods167 ET cases, enrolled in a prospective, longitudinal, clinical-pathological study, underwent an extensive neuropsychological testing battery at baseline (T1), 1.5 years (T2), and 3 years (T3). Results of these assessments informed clinical diagnoses of normal cognition (ET-NC), MCI (ET-MCI), and dementia (ET-D).ResultsAt baseline, 26 cases (82.7 ± 7.7 years) were diagnosed with ET-MCI and were available for follow-up at T2. At T2, three of 26 (11.5%) had converted to ET-D. At the start of T2, 23 cases (83.6 ± 7.7 years) were diagnosed with ET-MCI and were available for follow-up at T3. At T3, six of 23 (26.1%) converted to ET-D. The average annual conversion rate from ET-MCI to ET-D was 12.5%.ConclusionsThe study of cognitive impairment in ET is a nascent field, with limited data. We show that the conversion rate from ET-MCI to ET-dementia was 12.5%. Available studies on historical controls have reported conversion rates of 2.6–6.3%. Data such as these systematically fill gaps in knowledge, creating a scientifically-derived knowledge base to guide physicians and patients in clinical settings. |
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| Keywords: | Essential tremor Cognitive aging Movement disorders Dementia Cerebellar diseases |
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