Feelings of Helplessness in ET: A Preliminary Analysis of Prevalence and Clinical Correlates
Year: 2026
Type: article
Abstract: Essential tremor (ET) is a highly prevalent disease [1] or family of diseases [2] whose primary motor feature is kinetic tremor [3].In many patients, the tremor may become both severe [4] and disabling [5], and in patients with long-standing disease, the tremor may be incapacitating [6].Studies have reported that 15%-25% of patients with ET are forced to retire prematurely, and 60% choose not to apply for a job or promotion because of uncontrollable shaking [7,8].Tremor medications have been only partially successful at ameliorating patient's symptoms, leaving a high burden of under-treated and untreated disease [9].The impact of tremor among patients with ET is multi-dimensional, with patients experiencing both increased frailty [10] and lower morale [11] relative to age-matched controls; furthermore, increased caregiving intensity [12] and caregiver burden [13] have been reported in some cases.Given this clinical and therapeutic scenario, it is understandable that ET patients may at times feel helpless (i.e., experience feelings of having reduced control over aversive outcomes).To our knowledge, little is understood about helplessness in patients with ET.Hence, the goal of these preliminary analyses was to assess the prevalence of reported helplessness as well as its clinical correlates in indivduals with ET.ET cases were enrolled in a prospective, longitudinal, nationwide study of older adults with ET (Clinical Pathological Study of Cognitive Impairment in Essential Tremor [COGNET]; National Institutes of Health Awards #R01 NS086736 and #R01 NS145265), described in detail [14].To date, cases reside in 43 US states, having responded to an advertisement to enroll in this cohort [14].The Yale University, Columbia University, and University of Texas Southwestern Medical Center Institutional Review Boards approved the study protocol.All cases provided written, informed consent.During the in-home baseline evaluation, ET cases were asked, "Do you often feel helpless?",which was one of 30 questions in the Geriatric Depression Scale (GDS) [15].Data were available on 101 ET cases whose mean age was 79.8 ± 5.3 years (range = 65-96 years) and among whom 60 (59.4%) were women.Their mean total tremor score was 21.1 ± 6.1 (highest potential value = 36), indicating moderate action tremor on average, and 67 (66.4%) were taking mediation to treat their tremor.Twelve (11.9%, 95% confidence interval = 6.3% to 19.8%) of 101 reported that they often felt helpless.ET cases who reported feelings of helplessness had a higher mean total tremor score than did those who did not (25.0 ± 6.4 vs. 20.7 ± 5.9, Student's t test, p = 0.04).The two groups did not differ with respect to tremor duration (median durations = 23.0 vs. 31.0years, Mann Whitney test, p = 0.2).The total burden of medical illnesses as assessed using the Cumulative Illness Rating
DOI: 10.5334/tohm.1295
Author: Elan D. Louis
Institution: The University of Texas Southwestern Medical Center
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $800
OpenAlex ID: W7223172629