Objective: To evaluate the association between age of symptom onset and cognitive function in elderly individuals with Essential Tremor (ET).

Background: ET is one of the most common causes of tremor in older adults and is associated with various features that can affect functionality, including cognitive impairments. The onset of symptoms in ET follows a bimodal distribution, with two peaks: early and late. Late-onset ET may be linked to cognitive decline and dementia in affected individuals.

Method: This was a cross-sectional study with 71 older individuals with ET. To analyze the differences between elderly individuals with early onset of symptoms and those whose symptoms began with aging, the sample was divided into two groups: AOS<50 (Age of Onset of Symptoms <50 years) consisting of 19 individuals who showed symptoms before the age of fifty, and AOS>50, with 52 individuals who had the onset of symptoms after this age range. To assess cognitive function, the Montreal Cognitive Assessment (MoCA) scale was used. In the statistical analysis, for numerical variables that were not normally distributed, the Mann-Whitney U test was employed, while the t-test was used for normally distributed variables.

Results: The AOS<50 group had an average age of 33.8±13.8 years at symptom onset, while the AOS>50 group had an average of 65.8±7.9 years. No significant differences were observed in age between the two groups or in Body Mass Index (BMI). On the MoCA scale, the AOS<50 group scored significantly higher (p=0.005), indicating better cognitive performance compared to the AOS>50 group (Table 1).

Conclusion: The findings highlight that individuals with late-onset tremor symptoms had lower scores on the cognitive test. These patients possibly experience a faster progression due to reduced cognitive reserve and neuronal loss associated with aging. It is suggested that, despite a longer disease duration, individuals with an earlier onset of symptoms exhibit preserved cognitive functions.

Table 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-age-of-symptom-onset-in-essential-tremor-on-cognition-in-elderly-individuals/