Living Well

This Isn't a Normal Part of Aging

She played the Oscar-winning role of the frail, trembling, elderly Ethel Thayer. But her shaking wasn't part of the act...

The severe tremors in Katharine Hepburn's character in On Golden Pond were courtesy of the actress's disorder.

Many thought the leading lady had Parkinson's disease that made her head, voice, and hands shake. But she had a different condition, one that affects millions of Americans – especially older ones: essential tremor ("ET").

ET features involuntary, rhythmic shaking of the limbs. The disorder starts with faint tremors. As it worsens, you might have fewer tremors. But they may become stronger, bigger ones that affect your fine motor skills (like buttoning up your shirt or writing with a pen).

You can't prevent or cure ET. But you can minimize the symptoms by avoiding what makes it worse. Caffeine intake, stress, and sleep deprivation are some examples that I'll touch upon later. (By the way, I covered the threat that's coming for your sleep hygiene – and my two top tips on how to foil it – in my last issue of Retirement Millionaire. If you're interested, you can take a subscription for a test drive right here.)

Worldwide, 5% of older adults have ET. And about 10 million Americans have it. But the numbers could be higher...

That's because of misdiagnosis. Folks might also chalk it up to a natural part of getting older and don't bring it up to their doctor. Or they might fear their ET is a sign of Parkinson's disease and are too scared to get treatment. ET is similar to Parkinson's in that it's a movement disorder that progresses or worsens.

ET isn't a normal part of aging. Sure, it's more common in older adults. But it can appear at any age. And with ET, genetics comes into play – heavily so. It's estimated that ET is inherited in as many as 70% of cases. As Katharine Hepburn told Barbara Walters in an interview, "[The shaking] is from my grandfather... His hand shook and his head shook. And my head shakes."

There are some more differences between Parkinson's and ET:

  • ET is common in older adults, but it can start at any age. Parkinson's usually starts when you're in your 60s.
  • ET usually happen while you're completing a task (like eating) or holding posture, while Parkinson's tremors typically happen when you're at rest.
  • ET often shows up on both sides of the body, whereas Parkinson's tremors tend to show up on one side of the body before spreading to the other side.
  • Your head, hands, legs, and even voice might have tremors. With Parkinson's, the tremors don't usually affect your head and voice. But you get additional "classic" symptoms like balance problems, stiffness, and slower movements.
  • It can vary in terms of how much worse it gets over time. Everyone with Parkinson's will see their symptoms worsen, though.

One grim fact about Parkinson's is that up to 80% of sufferers develop dementia. As it turns out, having ET can raise your risk of dementia, too... That's according to a study published last week in the Annals of Neurology.

Starting in 2014, researchers followed a group of older adult ET patients for five years. Data from the 177 remaining participants showed that 19% of the folks had or developed dementia... which is "nearly three times higher than rates in the general population," as the study stated.

If your ET is disruptive enough to your daily life, though, your doc may recommend considering medication and/or surgery. A newer treatment option is high-intensity focused ultrasound. It's used to treat a wide range of conditions and tumors. With ET, it can reduce tremors by 70%. But this minimally invasive procedure can be costly.

However, if your tremors aren't severe enough to disrupt your everyday life, here are some tips to help make them less annoying...

Try these pinch hitters for coffee. Caffeine can worsen tremors. If you're looking to quit but crave the bitter taste of a good roast, give chicory or dandelion root a try. Caffeine-free coffee substitutes made from roasting chicory or dandelion root come pretty darn close to mimicking the bitter, nutty taste of a cup of joe. And acid-reflux sufferers rejoice... As a bonus, both beverages are low acid. Make sure you run it by your doctor, though, if you take daily medications. For instance, dandelion can make you pee more. So you could have an electrolyte imbalance if you take medications that have the same diuretic effect.

Make sure you're getting your magnesium. You need this stuff for regulating nerve impulses and contracting your muscles. So do what I do and pile your plate with greens. Leafy green vegetables like spinach, Swiss chard, and kale are great sources of magnesium. I always have them on hand in my freezer to toss into soups, casseroles, frittatas, and smoothies. Magnesium is also one of the very few supplements that I'm not against, too.

Subdue that stress. I know, I know. It's easier said than done. But stress and anxiety can really ramp up ET symptoms. So make sure you're doing the one thing you should be doing on a daily basis anyway... exercise. Working out helps prevent brain buildup of a chemical created in stress and inflammation called kynurenine. This chemical is also associated with Parkinson's, depression, and Alzheimer's disease. With exercise, your body produces more protein that transforms kynurenine so it can't cross the blood-brain barrier.

Of course, numerous studies support that regular exercise reduces dementia risk... A May 2023 review and meta-analysis found that at least 12 weeks of exercise can even reverse signs of cognitive decline.

Finally, an October 2023 study found that not getting enough deep sleep can raise your dementia risk if you're 60 or older. So make sure you top it all off with plenty of quality sleep to manage those tremors and lower your likelihood of developing dementia, too.

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
May 2, 2024