Volume 25, Issue 5 p. 534-541

How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor

Elan D. Louis MD, MSc

Corresponding Author

Elan D. Louis MD, MSc

GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA

Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA

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

Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA

Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032Search for more papers by this author
Joaquim J. Ferreira MD

Joaquim J. Ferreira MD

Neurological Clinical Research Unit, Institute of Molecular Medicine, Lisbon, Portugal

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First published: 21 April 2010
Citations: 610

Potential conflict of interest: Nothing to report.

This article is part of the journal's online CME program. The CME activity including form, can be found online at http://www.movementdisorders.org/education/journalcme/


Essential tremor (ET) is among the more prevalent neurological disorders, yet prevalence estimates have varied enormously, making it difficult to establish prevalence with precision. We: (1) reviewed the worldwide prevalence of ET in population-based epidemiological studies, (2) derived as precisely as possible an estimate of disease prevalence, and (3) examined trends and important differences across studies. We identified 28 population-based prevalence studies (19 countries). In a meta-analysis, pooled prevalence (all ages) = 0.9%, with statistically significant heterogeneity across studies (I2 = 99%, P < 0.001). In additional descriptive analyses, crude prevalence (all ages) = 0.4%. Prevalence increased markedly with age, and especially with advanced age. In the meta-analysis, prevalence (age ≥ 65 years) = 4.6%, and in additional descriptive analyses, median crude prevalence (age ≥ 60–65) = 6.3%. In one study of those age ≥ 95 years, crude prevalence = 21.7%. Several studies reported ethnic differences in prevalence, although more studies are needed. Greater than one-third of studies show a gender difference, with most demonstrating a higher prevalence among men. This possible gender preference is interesting given clinical, epidemiological, and pathological associations between ET and Parkinson's disease. Precise prevalence estimates such as those we provide are important because they form the numerical basis for planned public health initiatives, provide data on the background occurrence of disease for family studies, and offer clues about the existence of environmental or underlying biological factors of possible mechanistic importance. © 2010 Movement Disorder Society