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Enfeeblement in Elders with Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden.

Abstract

Background

Individuals with essential tremor (ET), a common movement disorder, experience functional impairment, which contributes to burden experienced by their loved ones and caregivers. Some burdened caregivers report their loved ones as seeming debilitated or prematurely old, a concept that we have called enfeeblement. Using the Essential Tremor Enfeeblement Survey (ETES), we seek to characterize enfeeblement in elders with ET and assess its contribution to caregiver burden.

Methods

We administered the ETES (range = 8-40, higher scores indicating more enfeeblement) and other scales to 98 caregivers of individuals with ET. Individuals with ET were also queried regarding tremors, cognitive abilities, and overall health. We then identified demographic and clinical correlates of ETES and modeled the contribution of ETES to caregiver burden (assessed using the Zarit 12-item Burden Interview [ZBI-12]).

Results

Mean ETES score was 14.2 ± 6.2 (median = 12.0, range = 8.0-32.0); 26.5% of respondents endorsed at least one of the eight ETES items. Older age, greater tremor severity and disability, more functional and gait disability, more cognitive difficulty, and more depressive symptoms were associated with higher ETES scores. ETES was the strongest contributor to caregiver burden (ZBI-12) and substantially increased the variance explained in models of caregiver burden.

Discussion

Enfeeblement seems to describe a previously unexplained component of caregiver burden in elders with ET. The presence of enfeeblement may contribute to greater burden and should be factored into assessments of patient and caregiver needs.

Authors+Show Affiliations

Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA. Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31709127

Citation

Cersonsky, Tess E K., et al. "Enfeeblement in Elders With Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden." Tremor and Other Hyperkinetic Movements (New York, N.Y.), vol. 9, 2019.
Cersonsky TEK, Diaz DT, Kellner S, et al. Enfeeblement in Elders with Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden. Tremor Other Hyperkinet Mov (N Y). 2019;9.
Cersonsky, T. E. K., Diaz, D. T., Kellner, S., Hickman, R., Zdrodowska, M. A., Monin, J. K., & Louis, E. D. (2019). Enfeeblement in Elders with Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden. Tremor and Other Hyperkinetic Movements (New York, N.Y.), 9, doi:10.7916/tohm.v0.687.
Cersonsky TEK, et al. Enfeeblement in Elders With Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden. Tremor Other Hyperkinet Mov (N Y). 2019;9 PubMed PMID: 31709127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enfeeblement in Elders with Essential Tremor: Characterizing the Phenomenon and Its Role in Caregiver Burden. AU - Cersonsky,Tess E K, AU - Diaz,Daniel Trujillo, AU - Kellner,Sarah, AU - Hickman,Ruby, AU - Zdrodowska,Maria Anna, AU - Monin,Joan K, AU - Louis,Elan D, Y1 - 2019/10/18/ PY - 2019/06/17/received PY - 2019/09/12/accepted PY - 2019/11/12/entrez PY - 2019/11/12/pubmed PY - 2019/11/12/medline KW - Movement disorders KW - caregiver burden KW - cognition KW - embarrassment KW - enfeeblement KW - essential tremor JF - Tremor and other hyperkinetic movements (New York, N.Y.) JO - Tremor Other Hyperkinet Mov (N Y) VL - 9 N2 - Background: Individuals with essential tremor (ET), a common movement disorder, experience functional impairment, which contributes to burden experienced by their loved ones and caregivers. Some burdened caregivers report their loved ones as seeming debilitated or prematurely old, a concept that we have called enfeeblement. Using the Essential Tremor Enfeeblement Survey (ETES), we seek to characterize enfeeblement in elders with ET and assess its contribution to caregiver burden. Methods: We administered the ETES (range = 8-40, higher scores indicating more enfeeblement) and other scales to 98 caregivers of individuals with ET. Individuals with ET were also queried regarding tremors, cognitive abilities, and overall health. We then identified demographic and clinical correlates of ETES and modeled the contribution of ETES to caregiver burden (assessed using the Zarit 12-item Burden Interview [ZBI-12]). Results: Mean ETES score was 14.2 ± 6.2 (median = 12.0, range = 8.0-32.0); 26.5% of respondents endorsed at least one of the eight ETES items. Older age, greater tremor severity and disability, more functional and gait disability, more cognitive difficulty, and more depressive symptoms were associated with higher ETES scores. ETES was the strongest contributor to caregiver burden (ZBI-12) and substantially increased the variance explained in models of caregiver burden. Discussion: Enfeeblement seems to describe a previously unexplained component of caregiver burden in elders with ET. The presence of enfeeblement may contribute to greater burden and should be factored into assessments of patient and caregiver needs. SN - 2160-8288 UR - https://www.unboundmedicine.com/medline/citation/31709127/Enfeeblement_in_Elders_with_Essential_Tremor:_Characterizing_the_Phenomenon_and_Its_Role_in_Caregiver_Burden L2 - http://dx.doi.org/doi:10.7916/tohm.v0.687 DB - PRIME DP - Unbound Medicine ER -