Objective: The primary objective was to estimate the crude prevalence (CP) of Essential Tremor (ET) in Northeast-Central Pennsylvania (NEC-PA), where the Geisinger Health System (GHS) serves. As a secondary analysis, we sought to assess crude prevalence by age group.

Background: ET is one of the most prevalent movement disorders worldwide, with an estimated prevalence of 1.33% in the general population [1]; however, its epidemiology remains incompletely understood. Although ET has historically been considered a benign condition, there is increasing evidence to suggest that ET is associated with cognitive decline [2, 3], increased disability, and higher risk of developing neurodegenerative disorders, such as Parkinson’s Disease (PD) [4, 5].  The presence of an aging population and unique environmental exposures in NEC-PA calls for further investigation into the prevalence of ET in this historically underserved region to improve diagnostic awareness, allocate adequate healthcare resources, and implement early intervention strategies.

Method: We identified all patients with at least one diagnosis of ET introduced by a neurologist, who were at least eighteen years old at data extraction and at least ten years old at the time of diagnosis. To refine the ET-only cohort, we excluded patients with differential diagnoses, such as drug-induced tremor, drug-induced parkinsonism, secondary tremors, secondary parkinsonism, atypical parkinsonism, ataxia, cerebellar ataxia, spinal cerebral atrophy, dystonia, or PD. We included as a denominator census data from NEC-PA, reported on April 1st, 2020. We excluded any patient diagnosed after that day and anyone not alive at that time.

Results: There were 145,325 total people in NEC-PA as of April 1st, 2020. Initially, 7894 patients with at least one ICD code for ET introduced by a neurologist within GHS were identified. After applying exclusion criteria, 2612 patients remained. CP was found to be 1.80% (95% CI: 1.73 – 1.87). The table and figure below show the prevalence by age group [table1, figure1]. Our data suggest a second-order polynomial increase in prevalence with age groups (R^2 = 0.9955).

Conclusion: We found the CP of ET in NEC-PA to be 1.80% (1.73% – 1.87%). Prevalence increases with age, as expected.

table1

figure1

References: 1. Louis ED, McCreary M. How common is essential tremor? Update on the worldwide prevalence of essential tremor. Tremor and Other Hyperkinetic Movements. 2021;11(1). doi:10.5334/tohm.632
2. Sinoff G, Badarny S. Mild Cognitive Impairment, Dementia, and Affective Disorders in Essent ial Tremor: A Prospective Study. Tremor and Other Hyperkinetic Movements. Published online 2014:Tremor and Other Hyperkinetic Movements. doi:10.7916/D85B00KN
3. Benito-León J, Louis ED, Bermejo-Pareja F. Population-based case-control study of cognitive function in essential tremor. Neurology. 2006;66(1):69-74. doi:10.1212/01.wnl.0000192393.05850.ec
4. Thenganatt MA, Jankovic J. The relationship between essential tremor and Parkinson’s disease. Parkinsonism Relat Disord. 2016;22:S162-S165. doi:10.1016/j.parkreldis.2015.09.032
5. Benito-Leon J, Louis ED, Bermejo-Pareja F. Risk of incident Parkinson’s disease and parkinsonism in essential tremor: a population based study. J Neurol Neurosurg Psychiatry. 2008;80(4):423-425. doi:10.1136/jnnp.2008.147223

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MDS Abstracts - https://www.mdsabstracts.org/abstract/essential-tremor-prevalence-in-northeast-central-pennsylvania/