Quality of life and its determinants in essential tremor

Introduction: Despite Essential Tremor (ET) being the commonest movement disorder, there are few studies on the quality of life (QOL) in patients with ET, with most studies employing generic questionnaires. Methods: We studied QOL in 50 patients with ET attending the outpatient of a hospital using the Quality of life in Essential Tremor (QUEST) questionnaire a disease specific QOL instrument. The severity of tremor was assessed using a modified Fahn Tolosa Marin tremor rating scale (mFTMRS), co morbid anxiety and depression were studied using the Hamilton Anxiety (HARS) and Depression (HDRS) rating scales respectively. We also analyzed the influence of gender, age at presentation, age of onset, duration of tremor, distribution of tremor, family history and use of medications on the QOL. Results: The mean age of onset of tremor was 32.2 ± 18.9 years, mean duration of tremor was 8.4 ± 10.0 years, mean QUEST summary index (QSI) was 24.2 ± 19.2; mean scores in each of the domains were as follows - physical 29.3 ± 26.7, psychosocial 36.4 ± 28.7, communication 23.9 ± 36.9, work & finance 23.5 ± 29.9, hobbies 6.8 ± 17.3. The QSI had significant positive correlation with the mFTMRS, HARS and HDRS. Gender, age at presentation, age of onset, duration of tremor, distribution of tremor, family history and use of medication did not influence the QOL. Conclusion: Psychosocial aspects are important in determining the QOL in patients with ET. Tremor severity, co morbid anxiety and depression are associated with a lower QOL whereas tremor characteristics like age of onset, duration, distribution do not influence the QOL.