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Objective:  Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET.   Methods:  In a longitudinal, prospective study of 141 elders with ET, we used Cox proportional-hazards models to estimate hazard ratios (HRs) for death.   Results:  The mean baseline age was 81.1 ± 8.8 years. During the follow-up interval, 27 (19.1%) died. Average time from baseline to death was 12.3 ± 8.7 months (range = 0.3–31.2). In univariate Cox regression models, older age (HR = 1.16,  p  < 0.001), lower Montreal Cognitive Assessment score (HR = 0.88,  p  = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53,  p  < 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07,  p  = 0.048), less balance confidence (HR = 0.98,  p  = 0.006), more falls (HR = 1.11,  p  = 0.003), and more tandem mis-steps (HR = 1.53,  p  = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14,  p  = 0.005), higher CDR score (HR = 3.80,  p  = 0.002) and higher GDS (HR = 1.11,  p  = 0.01) were independently associated with increased risk of mortality.   Conclusions:  This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.

What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders