Болезнь Эссенциального Тремора повышает риск развития деменции и легких когнитивных нарушений

Older adults with essential tremor have a higher burden of mild cognitive impairment (MCI) and dementia than the general population but a lower burden than adults with Parkinson disease (PD), according to findings published in Neurology. Approximately 2.2% of the US population is estimated to have essential tremor. Emerging evidence suggests that essential tremor is associated with cognitive decline and an increased risk for dementia. To quantify the occurrence and progression of cognitive impairment in essential tremor, researchers analyzed data from the Clinical Pathological Study of Cognitive Impairment in Essential Tremor (COGNET), a prospective, longitudinal study. Of 380 individuals enrolled in COGNET, 350 were included in the analysis. Participants underwent extensive neuropsychological testing during home-based visits at baseline and 18, 36, 54, 72, and 90 months. The prevalence and incidence of MCI and dementia in essential tremor were compared with rates reported in the general population and among patients with PD in a systematic review and meta-analysis. The data reinforce that cognitive decline is not incidental in [essential tremor], but a consistent clinical feature observed during the progression of the disease… The baseline cohort had a mean (SD) age of 79.6 (8.4) years, was 98.2% White, and comprised 60.6% women. Mean (SD) age at tremor onset was 42.2 (22.2) years. At baseline, the prevalence of MCI was 12.6%, and dementia was 6.3%. During follow-up, the cumulative prevalence of MCI was 22.0% and dementia was 14.6%. The cumulative incidence was 12.9% for MCI and 10.2% for dementia. The mean (SD) age at first diagnosis was 85.4 (7.3) years for MCI and 89.3 (5.9) years for dementia. The average annual conversion proportion from normal cognition to MCI was 3.5%, from normal cognition to dementia was 0.7%, and from MCI to dementia was 13.8%. The pooled cumulative prevalence of MCI was 21.4%, while the pooled cumulative prevalence of dementia was 15.9%. The pooled cumulative incidence was 12.7% for MCI and 10.1% for dementia. Compared with the general population, essential tremor was associated with a higher pooled cumulative prevalence of MCI (21.4% vs 13.9%) and dementia (15.9% vs 5.7%). Compared with PD, essential tremor was associated with a lower pooled cumulative prevalence of MCI (21.4% vs 46.0%) and dementia (15.9% vs 42.2%). Similarly, the pooled cumulative incidence of MCI was higher in essential tremor than in the general population (12.7% vs 7.5%) but lower than in PD (12.7% vs 25.9%). The pooled cumulative incidence of dementia was higher in essential tremor than in the general population (10.1% vs 6.1%) but lower than in PD (10.1% vs 28.1%). Study limitations include selection bias and attrition bias. Not all participants completed all follow-up evaluations, and those who completed all 6 evaluations were younger and had marginally higher Montreal Cognitive Assessment scores, which could have resulted in a slight underestimation of cognitive impairment, particularly at later evaluations. The study investigators concluded, “The data reinforce that cognitive decline is not incidental in [essential tremor], but a consistent clinical feature observed during the progression of the disease; the risk of MCI and dementia in [essential tremor], in fact, generally exceed age-expected rates in the general population.” This article originally appeared on Neurology Advisor References: Berry DS, Guy TO, Carter ED, et al. Estimates of incidence and prevalence of conversions to mild cognitive impairment and dementia in patients with essential tremor. Neurology. 2026;107(3):e218283. doi:10.1212/WNL.0000000000218283