What causes older people's hands to shake

Overview

Shaking hands, medically known as hand tremor, is a common concern, particularly as people age. While it can be a sign of a serious underlying condition, it's often benign and related to age-related changes or common conditions. Understanding the potential causes is the first step towards effective management and reassurance.

What is Hand Tremor?

A hand tremor is an involuntary, rhythmic shaking of the hands. It can range from barely noticeable to severe enough to interfere with daily activities like eating, writing, or dressing. Tremors can occur when the hands are at rest or when they are actively engaged in a task (action tremor).

Common Causes of Hand Tremor in Older Adults

Essential Tremor

Essential tremor (ET) is the most frequent cause of tremor in older adults. It's a neurological disorder that causes a rhythmic, involuntary shaking, most commonly affecting the hands. It can also affect the head, voice, and legs. ET typically begins subtly and worsens gradually over time. While it can start at any age, it becomes more prevalent after the age of 40 and its incidence increases with advancing age. For many, it's a mild inconvenience, but for others, it can significantly impact quality of life.

Parkinson's Disease

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects movement. While tremor is a hallmark symptom, it's not always the first one. Parkinsonian tremors are often characterized by a 'pill-rolling' motion and typically occur when the hand is at rest. This resting tremor often starts on one side of the body and may be accompanied by other symptoms like rigidity, slowness of movement (bradykinesia), and postural instability.

Medication Side Effects

A wide range of medications can cause or exacerbate tremors. This is a crucial cause to consider, especially in older adults who often take multiple medications (polypharmacy). Common culprits include certain asthma medications (like albuterol), antidepressants (especially selective serotonin reuptake inhibitors or SSRIs), anti-seizure drugs, thyroid medications, and stimulants used to treat ADHD. It's important to discuss all current medications with a healthcare provider if a tremor develops.

Thyroid Disorders

An overactive thyroid gland, known as hyperthyroidism, can speed up the body's metabolism, leading to a variety of symptoms, including a fine, rapid tremor, often affecting the hands. Other signs of hyperthyroidism include weight loss, rapid heart rate, anxiety, and heat intolerance. Conversely, an underactive thyroid (hypothyroidism) can sometimes cause a slower, more coarse tremor.

Other Neurological Conditions

While less common than ET or PD, other neurological conditions can cause tremors. These include:

• Multiple Sclerosis (MS): MS can cause intention tremors, which occur during voluntary movements.
• Stroke: Damage to certain brain areas due to a stroke can lead to tremors.
• Dystonia: A movement disorder that causes involuntary muscle contractions, which can sometimes manifest as tremor.

Lifestyle Factors

Even without an underlying medical condition, certain lifestyle factors can induce temporary tremors:

• Stress and Anxiety: Emotional distress can trigger or worsen tremors.
• Fatigue: Being overly tired can make tremors more noticeable.
• Caffeine Intake: High consumption of caffeine can stimulate the nervous system and lead to shakiness.
• Alcohol Withdrawal: Abrupt cessation of alcohol can cause significant tremors.

When to See a Doctor

It's advisable to consult a healthcare professional if:

• The tremor is new or has recently worsened.
• It interferes with daily activities.
• It's accompanied by other concerning symptoms like muscle stiffness, changes in walking, or slurred speech.
• You suspect a medication might be the cause.

A doctor can perform a physical examination, review your medical history and medications, and may order tests (like blood work to check thyroid function or neurological assessments) to determine the cause of the tremor and recommend appropriate treatment or management strategies.