Louis E D, Wendt K J, Ford B
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, N.Y., USA.
Gerontology. 2000 Jan-Feb;46(1):12-6. doi: 10.1159/000022127.
BACKGROUND/SETTING: It is well recognized that mild tremor is common among older adults, but the prevalence and clinical characteristics of this tremor have not been studied in detail.
To examine a cohort of normal older adults to: (1) ascertain the prevalence of mild test-detectible tremor; (2) quantify the severity and functional impact of this tremor, and (3) determine whether age, gender and concomitant illness predict the severity of tremor.
76 normal older adults >55 years of age (mean age = 73.7 years).
Healthy older adults were identified in a community-based case-control study of essential tremor in Washington Heights-Inwood, New York. All subjects underwent a medical interview and a videotaped neurological examination. The examination included six tests: arm extension, pouring water, drinking water, using a spoon, finger-to-nose movements, and drawing spirals with each arm. Two neurologists rated the severity of tremor using a 0 to +3 clinical rating scale and a total tremor score (TTS) was calculated (range = 0-36). Forward stepwise linear regression was used to determine the association between TTS and other variables.
Virtually all (75 or 98.7%) showed signs of tremor (TTS > 0.5). The mean TTS = 6.3 (range = 0-14.5), corresponding to a tremor that was either mild or intermittent. Twenty-eight of 76 (36.8%) received tremor ratings of +2 (clearly oscillatory tremor of moderate amplitude and usually present) during at least one of the six tests; a tremor rating of +2 was 2.1 times more likely to occur in the nondominant than in the dominant hand. Those who were aged 57-74 years had a lower mean TTS (5.8) than those aged 75-93 (6.8), but this was not significant. Only 2 patients (2.6%) answered 'yes' to the question 'do you have uncontrollable shaking in your hands?' None was taking medication to treat tremor. Gender, ethnicity, concomitant illness (diabetes, arthritis, heart disease), and medications were not associated with a higher TTS.
Mild but test-detectible tremor was present in almost all normal older adults, and in one-third this tremor attained a moderate amplitude during at least one activity. Characterization of this tremor would be of value to practitioners who care for older adults.
背景/环境：人们普遍认识到，轻度震颤在老年人中很常见，但这种震颤的患病率和临床特征尚未得到详细研究。
对一组正常老年人进行研究，以：（1）确定轻度可检测震颤的患病率；（2）量化这种震颤的严重程度和功能影响，以及（3）确定年龄、性别和伴随疾病是否可预测震颤的严重程度。
76名年龄大于55岁的正常老年人（平均年龄 = 73.7岁）。
在纽约华盛顿高地 - 因伍德进行的一项基于社区的特发性震颤病例对照研究中确定健康的老年人。所有受试者均接受了医学访谈和录像神经学检查。检查包括六项测试：手臂伸展、倒水、喝水、使用勺子、指鼻运动以及用每只手臂画螺旋线。两名神经科医生使用0至 +3临床评级量表对震颤严重程度进行评级，并计算总震颤评分（TTS）（范围 = 0 - 36）。采用向前逐步线性回归来确定TTS与其他变量之间的关联。
几乎所有（75名或98.7%）都表现出震颤迹象（TTS > 0.5）。平均TTS = 6.3（范围 = 0 - 14.5），对应于轻度或间歇性震颤。76名中有28名（36.8%）在六项测试中的至少一项中获得了 +2级震颤评级（明显的中等幅度振荡性震颤且通常存在）；在非优势手出现 +2级震颤评级的可能性是优势手的2.1倍。年龄在57 - 74岁的人的平均TTS（5.8）低于75 - 93岁的人（6.8），但差异不显著。只有2名患者（占2.6%）对“您的手部有无法控制的颤抖吗？”这个问题回答“是”。没有人正在服用治疗震颤的药物。性别、种族、伴随疾病（糖尿病、关节炎、心脏病）和药物与较高的TTS无关。
几乎所有正常老年人都存在轻度但可检测到的震颤，并且其中三分之一的人在至少一项活动中震颤达到中等幅度。了解这种震颤的特征对于照顾老年人的从业者具有重要价值。
