Hand Tremors in Seniors: When to Seek Medical Advice

Elderly individuals may experience hand tremors recently?

Hello Doctor: My mother is currently 65 years old and runs a small eatery with my father, who has not yet retired.
Recently, when I returned home, I noticed that while she was serving vegetables to customers, one hand was holding a takeout box and the other was using tongs to serve.
The hand holding the takeout box was shaking quite noticeably.
I don't recall her having this issue before.
Should we consult a specific type of doctor or conduct any tests, or is there anything we should pay attention to? Additionally, I haven't noticed any significant memory issues with her, but as she ages, her memory may not be as sharp.
Thank you.

Ms. Li, 30~39 year old female. Ask Date: 2021/02/21

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it seems that your mother may have a tremor issue.
Additionally, early-stage dementia should be considered.
The causes of tremors can be categorized into four types: physiological tremors, psychological tremors, essential tremors, and pathological tremors.
1.
Physiological tremors: These do not occur under normal circumstances and only manifest in specific situations such as stress, anxiety, or anger.
Certain medications, such as bronchodilators, as well as the consumption of beverages like coffee, tea, or cola, can also lead to physiological tremors.
2.
Psychological tremors: These may occur intermittently without a fixed pattern.
Treatment focuses on addressing the underlying mental health issues and managing stress.
3.
Essential tremors: The exact cause of these tremors is often unknown; they may be due to a unique physiological condition or hereditary factors.
Typically, individuals may experience more tremors when holding objects, while others may tremble when writing or performing specific movements.
4.
Pathological tremors: These are caused by dysfunction in the nervous system, such as in Parkinson's disease, lesions in the midbrain, cerebellum, or basal ganglia, or metabolic abnormalities (like hypoglycemia or hyperthyroidism).
These types of tremors tend to be more persistent.
I recommend consulting a neurologist to discuss and rule out pathological tremors and explore treatment options.
Wishing you good health and peace.

Dr.
Jiang Junyi, Neurology, Taoyuan Hospital.

Reply Date: 2021/02/21

More Info

Understanding hand tremors in seniors can be a complex issue, as it may stem from various underlying conditions. In your case, your mother, who is 65 years old, has recently exhibited noticeable tremors in her hand while performing everyday tasks, such as serving food at your family’s eatery. This change in her motor function is certainly worth investigating further.

Hand tremors can be categorized into several types, with the most common being essential tremor and Parkinson's disease-related tremors. Essential tremor is often characterized by shaking that occurs during voluntary movements, such as holding a utensil or reaching for an object. It is usually benign but can become more pronounced with age or stress. On the other hand, tremors associated with Parkinson's disease typically manifest at rest and may be accompanied by other symptoms such as stiffness, bradykinesia (slowness of movement), and postural instability.

Given that your mother has not previously exhibited such symptoms, it is advisable to seek medical advice. The first step would be to schedule an appointment with her primary care physician, who can conduct a thorough evaluation. The physician may perform a neurological examination to assess her motor skills, reflexes, and coordination. Depending on the findings, they may refer her to a neurologist for further assessment, especially if there are concerns about Parkinson's disease or other neurological conditions.

In addition to the physical examination, the doctor may recommend certain tests to rule out other causes of tremors. These could include blood tests to check for thyroid function, electrolyte imbalances, or other metabolic issues. Imaging studies, such as an MRI or CT scan, may also be warranted to evaluate the brain for any structural abnormalities.

It is also essential to monitor any accompanying symptoms that may arise. While you mentioned that your mother does not seem to have significant memory issues, it is still important to keep an eye on her cognitive function. Changes in memory, confusion, or difficulty concentrating can sometimes accompany tremors and may indicate a more complex neurological issue.

In the meantime, there are some practical steps you can take to help your mother manage her tremors. Encouraging her to use adaptive utensils designed for individuals with tremors can make eating and serving food easier. These utensils often have larger, ergonomic handles that provide a better grip and reduce the impact of shaking.

Additionally, reducing stress and anxiety can help minimize tremors. Encourage her to engage in relaxation techniques such as deep breathing exercises, yoga, or meditation. Regular physical activity, as long as it is safe and appropriate for her, can also improve overall motor function and coordination.

In summary, while hand tremors in seniors can be benign, they can also indicate underlying health issues that require attention. It is crucial to consult a healthcare professional to determine the cause of your mother’s tremors and to discuss appropriate management strategies. Early intervention can lead to better outcomes and improve her quality of life.

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