Profiles of Normal Cognition in Essential Tremor.

J Int Neuropsychol Soc 2019 Oct 4:1-13. Epub 2019 Oct 4.

Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.

Objectives: Patients with essential tremor exhibit heterogeneous cognitive functioning. Although the majority of patients fall under the broad classification of cognitively "normal," essential tremor is associated with increased risk for mild cognitive impairment and dementia. It is possible that patterns of cognitive performance within the wide range of normal functioning have predictive utility for mild cognitive impairment or dementia. These cross-sectional analyses sought to determine whether cognitive patterns, or "clusters," could be identified among individuals with essential tremor diagnosed as cognitively normal. We also determined whether such clusters, if identified, were associated with demographic or clinical characteristics of patients.

Methods: Elderly subjects with essential tremor (age >55 years) underwent comprehensive neuropsychological testing. Domain means (memory, executive function, attention, visuospatial abilities, and language) from 148 individuals diagnosed as cognitively normal were partitioned using k-means cluster analysis. Individuals in each cluster were compared according to cognitive functioning (domain means and test scores), demographic factors, and clinical variables.

Results: There were three clusters. Cluster 1 (n = 64) was characterized by comparatively low memory scores (p < .001), Cluster 2 (n = 39) had relatively low attention and visuospatial scores (p < .001), and Cluster 3 (n = 45) exhibited consistently high performance across all domains. Cluster 1 had lower Montreal Cognitive Assessment scores and reported more prescription medication use and lower balance confidence.

Conclusions: Three patterns of cognitive functioning within the normal range were evident and tracked with certain clinical features. Future work will examine the extent to which such patterns predict conversion to mild cognitive impairment and/or dementia.

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1355617719001140DOI Listing
October 2019
1 Read

Publication Analysis

Top Keywords

essential tremor
20
cognitive impairment
12
mild cognitive
12
cognitive functioning
12
cognitive
9
impairment dementia
8
scores 001
8
cognitively normal
8
diagnosed cognitively
8
attention visuospatial
8
patterns cognitive
8
001 cluster
8
cluster
6
tremor
5
essential
5
partitioned k-means
4
cluster compared
4
compared cognitive
4
individuals cluster
4
analysis individuals
4

References

(Supplied by CrossRef)

Wechsler et al.
1997

Wechsler et al.
1987
Mild cognitive impairment, dementia, and affective disorders in essential tremor: a prospective study
Sinoff et al.
Tremor and Other Hyperkinetic Movements (New York, NY) 2014

Similar Publications