Cognitive trajectories in older adults with essential tremor.

IF 2.6 4区心理学 Q2 CLINICAL NEUROLOGY

Journal of the International Neuropsychological Society Pub Date : 2025-08-18 DOI:10.1017/S1355617725101069

Samantha A Dargie, Silvia Chapman, Sandra Rizer, Ali Ghanem, Diane S Berry, Edward D Huey, Elan D Louis, Stephanie Cosentino

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引用次数: 0

Abstract

Objective: Despite recent attention to the increased risk of cognitive impairment in older adults with essential tremor (ET), there are only limited data on the trajectories of cognitive change in ET or the demographic and motor predictors of such change.

Method: This study included 148 cognitively normal individuals with ET (mean age = 76.7 ± 9.7 years) at baseline and had at least one follow-up evaluation (mean years of observation = 5.2 ± 1.6). Generalized Estimating Equations examined rates of change in six composite cognitive outcomes as a function of time, as well as demographic (age, sex, and education) and motor predictors (tremor severity, age of tremor onset, presence of rest tremor, cranial tremor, intention tremor, tandem gait) of rates of change. Demographics, medication use, and mood symptoms at baseline were covariates for all models.

Results: Participants evidenced a decline in global cognition, executive function, and attention (p _range = <0.001-0.044) over time. Older age predicted faster decline in all cognitive outcomes except attention (p _range =<0.001-0.025). Tremor severity predicted faster decline in executive function (p = 0.011). Rest tremor predicted faster decline in executive function and attention (p = 0.033, 0.017). Tandem gait missteps predicted faster decline in memory and visuospatial ability (p = 0.026, 0.028).

Conclusions: Results point to a dissociation in the predictive value of different motor features for specific aspects of cognitive decline. These results shed light on the earliest manifestations of cognitive impairment in older adults with ET and implicate different pathways by which heterogeneous cognitive changes emerge.

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老年特发性震颤患者的认知轨迹。

目的：尽管最近人们注意到老年特发性震颤（ET）患者认知功能障碍的风险增加，但关于ET认知变化的轨迹或这种变化的人口统计学和运动预测因子的数据有限。方法：本研究纳入148例认知正常ET患者（平均年龄为76.7±9.7岁），并至少进行一次随访评估（平均观察年数为5.2±1.6年）。广义估计方程检查了六种复合认知结果的变化率，作为时间的函数，以及人口统计学（年龄、性别和教育）和运动预测因子（震颤严重程度、震颤发作年龄、静止性震颤的存在、颅震颤、意图性震颤、串联步态）的变化率。所有模型的协变量包括人口统计学、药物使用和基线时的情绪症状。结果：参与者表现出整体认知、执行功能和注意力的下降（p range =p range =p = 0.011）。静息性震颤预示执行功能和注意力下降更快（p = 0.033, 0.017）。串联步态失误预示着记忆和视觉空间能力的更快下降（p = 0.026, 0.028）。结论：研究结果表明，不同运动特征对认知衰退特定方面的预测价值存在分离。这些结果揭示了老年ET患者认知障碍的早期表现，并暗示了异质认知变化出现的不同途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the International Neuropsychological Society 医学-精神病学

CiteScore

5.40

自引率

3.80%

发文量

185

审稿时长

4-8 weeks

期刊介绍： The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate. To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.