Objective: We examined the relationship between cognitive performance and gait in essential tremor (ET).

Background: ET is not exclusively a motor disorder; it is associated on several levels with cognitive dysfunction. We hypothesized that a correlate of cognitive dysfunction in ET patients would be greater problems with gait and balance.

Methods: ET cases were recruited into the Clinical-pathological Study of Cognition in Essential Tremor. A comprehensive cognitive battery was performed. This included the Montreal Cognitive Assessment (MoCA) and assignment of Clinical Dementia Rating (CDR) scores. We collected data on the number of falls in the past year, and balance confidence was assessed using the six-item Activities of Balance Confidence Scale. These cross-sectional analyses utilized baseline data.

Results: There were 199 ET cases (mean age 78.6 years). In linear regression models that considered the effects of numerous confounding variables, lower MoCA score (poorer cognition) was associated with greater number of falls and reduced balance confidence (p<0.05). In similar adjusted models, higher CDR score (poorer cognition) was associated with greater number of falls and reduced balance confidence (p<0.05). We also assessed whether performance in each cognitive domain was associated with number of falls and balance confidence. Number of falls was most closely linked with executive function, and balance confidence, with executive function, attention and memory.

Conclusions: These data indicate that a correlate of poorer cognition in ET is greater number of falls and lower balance confidence. Cognition should enter the clinical dialog with ET patients as an issue of clinical significance.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-dysfunction-is-associated-with-greater-imbalance-and-falls-in-patients-with-essential-tremor/