Effect of Orthostatic Tremor on Quality of Life - a Cohort Study.

Abstract

Background: Orthostatic tremor (OT) is characterized by a lower extremity tremor causing unsteadiness while standing, urging patients to lean, walk, or sit to ease symptoms. This severely disrupts daily life and reduces quality of life (QoL), though the extent of QoL impairment remains largely unknown. The objective of this cohort study was to evaluate the effect of OT on daily functioning and well-being over time.

Methods: In this prospective single-center and community based cohort study, OT patients annually completed self-report scales from 2018 to 2024, including the Dutch OT-questionnaire, Hospital Anxiety and Depression Scale (HADS), (instrumental) Activities of Daily Living, and the Short Form-36 (SF-36) to evaluate QoL.

Results: Fifty-three OT patients participated in the study. OT patients showed reduced well-being compared to the general population based on outcomes from the SF-36 and HADS, with 30 out of 53 patients experiencing potential or suspected depression and/or anxiety. Despite viewing OT as progressive, most patients saw no significant changes in overall well-being or daily functioning, although a significant difference was found between baseline and last follow-up for physical role limitation.

Discussion: Although OT patients report reduced well-being, both daily functioning and overall well-being remained stable over time, despite progressive symptoms. This is likely due to patients increased ability to adapt to OT symptoms. Additionally, a substantial portion had potential or suspected depression or anxiety.

Highlights: Orthostatic tremor (OT) patients report reduced quality of life, with worsened walking ability and increased weather sensitivity over time. Despite this, daily functioning and overall well-being remained stable throughout the study. A significant portion of patients also showed potential or suspected depression and/or anxiety.