Skip to content
naulon

No retraction, correction or concern found when last checked on Oct 20, 2026.

How Common is Essential Tremor? Update on the Worldwide Prevalence of Essential Tremor

Elan D. Louis, Morgan McCreary

Tremor and Other Hyperkinetic Movements · 2021 · Meta-analysis

doi:10.5334/tohm.632

Abstract

Background:. Essential tremor (ET) is among the most prevalent movement disorders. Comprehensive reviews of disease prevalence were published in 1998 and 2010 but not since then. We reviewed the prevalence of ET in population-based epidemiological studies, derived a precise summary estimate of prevalence from these studies, and examined differences in prevalence across studies. We used two methods: a descriptive-analytical approach and a meta-analysis.

Methods:. A PUBMED search yielded 14 published papers since the 2010 review.

Results:. There were 42 population-based prevalence studies (23 countries and 6 continents). In a meta-analysis, pooled prevalence (all ages) = 1.33%, with statistically significant heterogeneity across studies (I2 = 99.3%, p < 0.0001). In additional descriptive analyses, median crude prevalence (all ages) = 0.4% and mean = 0.67%. Prevalence increased markedly with age, and especially with advanced age. In the meta-analysis, prevalence (age ≥ 65 years) = 5.79%, and in descriptive analyses, median crude prevalence (age ≥ 60–65) = 5.9% and mean = 8.0%. In the oldest age groups, median prevalence = 9.3%, with several studies reporting values >20%. The prevalence increased by 74% for every decade increase in age (p < 0.0001). Gender did not impact the prevalence of ET (p = 0.90).

Discussion:. Precise prevalence estimates are important because they form the numerical basis for public health initiatives and offer clues about underlying biological factors of mechanistic importance. The prevalence of ET among those age ≥ 65 is similar to that reported for Alzheimer’s disease in elders, suggesting that ET may be the most common neurodegenerative disease.

References 78

  1. 1.

    Louis ED, Faust PL. Essential tremor: the most common form of cerebellar degeneration? Cerebellum Ataxias, 2020; 7: 12

    Not in our library10.1186/s40673-020-00121-1

  2. 2.

    Louis ED, Ottman R. How many people in the USA have essential tremor? Deriving a population estimate based on epidemiological data. Tremor Other Hyperkinet Mov (N Y). 2014; 4: 259

    Not in our library10.5334/tohm.198

  3. 3.

    Sempere AP, Medrano V, Pardo-Franco JL, Callejo-Dominguez JM, Delsors Merida-Nicolich E, Mola S. Aetiological analysis of 425 patients referred to an outpatient neurology service due to tremor or Parkinsonism. Rev Neurol. 2010; 51: 81–84

    Not in our library10.33588/rn.5102.2010165

  4. 4.

    Truax WD. Five common tremors. Classification, key to therapy. Postgrad Med. 1983; 74: 68–73

    Not in our library10.1080/00325481.1983.11697901

  5. 5.

    Charles PD, Esper GJ, Davis TL, Maciunas RJ, Robertson D. Classification of tremor and update on treatment. Am Fam Physician. 1999; 59: 1565–1572.

    Not in our library

  6. 6.

    Crawford P, Zimmerman EE. Tremor: Sorting Through the Differential Diagnosis. Am Fam Physician. 2018; 97: 180–186.

    Not in our library

  7. 7.

    Sirisena D, Williams DR. My hands shake–classification and treatment of tremor. Aust Fam Physician. 2009; 38: 678–683.

    Not in our library

  8. 8.

    Alty JE, Kempster PA. A practical guide to the differential diagnosis of tremor. Postgrad Med J. 2011; 87: 623–629

    Not in our library10.1136/pgmj.2009.089623

  9. 9.

    Louis ED, Ottman R, Hauser WA. How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord. 1998; 13: 5–10

    Not in our library10.1002/mds.870130105

  10. 10.

    Dogu O, Sevim S, Camdeviren H, et al. Prevalence of essential tremor: door-to-door neurologic exams in Mersin Province, Turkey. Neurology. 2003; 61: 1804–1806

    Not in our library10.1212/01.wnl.0000099075.19951.8c

  11. 11.

    Rautakorpi I, Takala J, Marttila RJ, Sievers K, Rinne UK. Essential tremor in a Finnish population. Acta Neurol Scand. 1982; 66: 58–67

    Not in our library10.1111/j.1600-0404.1982.tb03129.x

  12. 12.

    Larsson T, Sjogren T. Essential tremor: a clinical and genetic population study. Acta Psychiatr Scand Suppl. 1960; 36: 1–176.

    Not in our library

  13. 13.

    Louis ED, Marder K, Cote L, et al. Differences in the prevalence of essential tremor among elderly African Americans, whites, and Hispanics in northern Manhattan, NY. Arch Neurol. 1995; 52: 1201–1205

    Not in our library10.1001/archneur.1995.00540360079019

  14. 14.

    Louis ED, Ferreira JJ. How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov Disord. 2010; 25: 534–541

    Not in our library10.1002/mds.22838

  15. 15.

    Balduzzi S, Rucker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health. 2019; 22: 153–160

    Not in our library10.1136/ebmental-2019-300117

  16. 16.

    Viechtbauer W. Conducting meta-analyses in R with the metafor package. Journal of Statistical Software. 2010; 36(3): 1–48

    Not in our library10.18637/jss.v036.i03

  17. 17.

    Team RC. A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/. 2021.

    Not in our library

  18. 18.

    Wickham H. Elegant Graphics for Data Analysis. New York: Springer-Verlag; 2016.

    Not in our library

  19. 19.

    Das SK, Biswas A, Roy J, et al. Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata. J Assoc Physicians India. 2008; 56: 175–181.

    Not in our library

  20. 20.

    Das SK, Banerjee TK, Roy T, Raut DK, Chaudhuri A, Hazra A. Prevalence of essential tremor in the city of Kolkata, India: a house-to-house survey. Eur J Neurol. 2009; 16: 801–807

    Not in our library10.1111/j.1468-1331.2009.02589.x

  21. 21.

    Inzelberg R, Mazarib A, Masarwa M, Abuful A, Strugatsky R, Friedland RF. Essential tremor prevalence is low in Arabic villages in Israel: door-to-door neurological examinations. J Neurol. 2006; 253: 1557–1560

    Not in our library10.1007/s00415-006-0253-5

  22. 22.

    Liu HC, Wang SJ, Fuh JL, et al. The Kinmen Neurological Disorders Survey (KINDS): a study of a Chinese population. Neuroepidemiology. 1997; 16: 60–68

    Not in our library10.1159/000109672

  23. 23.

    Osuntokun BO, Adeuja AO, Schoenberg BS, et al. Neurological disorders in Nigerian Africans: a community-based study. Acta Neurol Scand. 1987; 75: 13–21

    Not in our library10.1111/j.1600-0404.1987.tb07883.x

  24. 24.

    Li SC, Schoenberg BS, Wang CC, et al. A prevalence survey of Parkinson’s disease and other movement disorders in the People’s Republic of China. Arch Neurol. 1985; 42: 655–657

    Not in our library10.1001/archneur.1985.04060070045013

  25. 25.

    Dotchin CL, Walker RW. The prevalence of essential tremor in rural northern Tanzania. J Neurol Neurosurg Psychiatry. 2008; 79: 1107–1109

    Not in our library10.1136/jnnp.2007.134304

  26. 26.

    Haimanot RT, Abebe M, Mariam AG, et al. Community-based study of neurological disorders in Ethiopia: development of a screening instrument. Ethiop Med J. 1990; 28: 123–137.

    Not in our library

  27. 27.

    al Rajeh S, Bademosi O, Ismail H, et al. A community survey of neurological disorders in Saudi Arabia: the Thugbah study. Neuroepidemiology. 1993; 12: 164–178

    Not in our library10.1159/000110316

  28. 28.

    Attia Romdhane N, Ben Hamida M, Mrabet A, et al. Prevalence study of neurologic disorders in Kelibia (Tunisia). Neuroepidemiology. 1993; 12: 285–299

    Not in our library10.1159/000110330

  29. 29.

    Tan LC, Venketasubramanian N, Ramasamy V, Gao W, Saw SM. Prevalence of essential tremor in Singapore: a study on three races in an Asian country. Parkinsonism Relat Disord. 2005; 11: 233–239

    Not in our library10.1016/j.parkreldis.2005.01.002

  30. 30.

    Chouza CKC, Caamano JL. Prevalence of Parkinson’s disease in a population of Uruguay: preliminary results. New Trends Clin Neuropharmacol. 1994; 8: 122.

    Not in our library

  31. 31.

    Hornabrook RW, Nagurney JT. Essential tremor in Papua, New Guinea. Brain. 1976; 99: 659–672

    Not in our library10.1093/brain/99.4.659

  32. 32.

    Salemi G, Savettieri G, Rocca WA, et al. Prevalence of essential tremor: a door-to-door survey in Terrasini, Sicily. Sicilian Neuro-Epidemiologic Study Group. Neurology. 1994; 44: 61–64

    Not in our library10.1212/wnl.44.1.61

  33. 33.

    Haerer AF, Anderson DW, Schoenberg BS. Prevalence of essential tremor. Results from the Copiah County study. Arch Neurol. 1982; 39: 750–751

    Not in our library10.1001/archneur.1982.00510240012003

  34. 34.

    Acosta ECE, Obeso JA. Prevalence of Parkinson’s disease and essential tremor in a village of south Spain. Neurology. 1989; 39(Suppl 1): 181.

    Not in our library

  35. 35.

    Glik A, Masarwa M, Abuful A, et al. Essential tremor might be less frequent than Parkinson’s disease in North Israel Arab villages. Mov Disord. 2009; 24: 119–122

    Not in our library10.1002/mds.22324

  36. 36.

    Mancini ML, Stracci F, Tambasco N, Sarchielli P, Rossi A, Calabresi P. Prevalence of essential tremor in the territory of Lake Trasimeno, Italy: results of a population-based study. Mov Disord. 2007; 22: 540–545

    Not in our library10.1002/mds.21349

  37. 37.

    Bharucha NE, Bharucha EP, Bharucha AE, Bhise AV, Schoenberg BS. Prevalence of essential tremor in the Parsi community of Bombay, India. Arch Neurol. 1988; 45: 907–908

    Not in our library10.1001/archneur.1988.00520320105023

  38. 38.

    Sur H, Ilhan S, Erdogan H, Ozturk E, Tasdemir M, Boru UT. Prevalence of essential tremor: a door-to-door survey in Sile, Istanbul, Turkey. Parkinsonism Relat Disord. 2009; 15: 101–104

    Not in our library10.1016/j.parkreldis.2008.03.009

  39. 39.

    Bergareche A, De La Puente E, Lopez De Munain A, et al. Prevalence of essential tremor: a door-to-door survey in bidasoa, spain. Neuroepidemiology. 2001; 20: 125–128

    Not in our library10.1159/000054771

  40. 40.

    Benito-Leon J, Bermejo-Pareja F, Morales JM, Vega S, Molina JA. Prevalence of essential tremor in three elderly populations of central Spain. Mov Disord. 2003; 18: 389–394

    Not in our library10.1002/mds.10376

  41. 41.

    Louis ED, Thawani SP, Andrews HF. Prevalence of essential tremor in a multiethnic, community-based study in northern Manhattan, New York, N.Y. Neuroepidemiology. 2009; 32: 208–214

    Not in our library10.1159/000195691

  42. 42.

    Moghal S, Rajput AH, D’Arcy C, Rajput R. Prevalence of movement disorders in elderly community residents. Neuroepidemiology. 1994; 13: 175–178

    Not in our library10.1159/000110376

  43. 43.

    Khatter AS, Kurth MC, Brewer MA, et al. Prevalence of tremor and Parkinson’s disease. Parkinsonism Relat Disord. 1996; 2: 205–208

    Not in our library10.1016/s1353-8020(96)00027-2

  44. 44.

    Wenning GK, Kiechl S, Seppi K, et al. Prevalence of movement disorders in men and women aged 50–89 years (Bruneck Study cohort): a population-based study. Lancet Neurol. 2005; 4: 815–820

    Not in our library10.1016/s1474-4422(05)70226-x

  45. 45.

    Louis ED, Hafeman D, Parvez F, et al. Prevalence of essential tremor in Araihazar, Bangladesh: a population-based study. Neuroepidemiology. 2011; 36: 71–76

    Not in our library10.1159/000323389

  46. 46.

    Liu Y, Zhang XY, Tang YZ, et al. Investigation on prevalence rate of essential tremor in population aged 55 years old and above in Kashkar, between 2008 and 2009. Zhonghua Yi Xue Za Zhi. 2011; 91: 1067–1069.

    Not in our library

  47. 47.

    Okubadejo NU, Bankole IA, Ojo OO, Ojini FI, Danesi MA. Prevalence of essential tremor in urban Lagos, Nigeria: a door-to-door community-based study. BMC Neurol. 2012; 12: 110

    Not in our library10.1186/1471-2377-12-110

  48. 48.

    Aharon-Peretz J, Badarny S, Ibrahim R, Gershoni-Baruch R, Hassoun G. Essential Tremor Prevalence is Low in the Druze Population in Northern Israel. Tremor Other Hyperkinet Mov (N Y). 2012; 2

    Not in our library10.5334/tohm.90

  49. 49.

    Ozel L, Demir R, Ozdemir G, et al. Investigation of the prevalence of essential tremor in individuals aged 18–60 in Erzurum. Acta Neurol Belg. 2013; 113: 127–131

    Not in our library10.1007/s13760-012-0147-5

  50. 50.

    Barbosa MT, Caramelli P, Cunningham MC, Maia DP, Lima-Costa MF, Cardoso F. Prevalence and clinical classification of tremor in elderly–a community-based survey in Brazil. Mov Disord. 2013; 28: 640–646

    Not in our library10.1002/mds.25355

  51. 51.

    Seijo-Martinez M, Del Rio MC, Alvarez JR, et al. Prevalence of Essential Tremor on Arosa Island, Spain: a Community-based, Door-to-Door Survey. Tremor Other Hyperkinet Mov (N Y). 2013; 3

    Not in our library10.5334/tohm.130

  52. 52.

    Oh ES, Kim JM, Kim YE, et al. The prevalence of essential tremor in elderly Koreans. J Korean Med Sci. 2014; 29: 1694–1698

    Not in our library10.3346/jkms.2014.29.12.1694

  53. 53.

    Yao Y, Wang Y, Yang X. Related factors and prevalence for the essential tremor disease of Uygur residents in Hetian, Xinjiang UygurAutonomous Region. Zhonghua Yi Xue Za Zhi. 2015; 95: 69–72.

    Not in our library

  54. 54.

    Louis ED, Factor-Litvak P. Screening for and Estimating the Prevalence of Essential Tremor: A Random-Digit Dialing-Based Study in the New York Metropolitan Area. Neuroepidemiology 2016; 46: 51–56

    Not in our library10.1159/000442576

  55. 55.

    Eliasen EH, Ferrer M, Gaini S, Louis ED, Petersen MS. Prevalence of Essential Tremor in the Faroe Islands: A Population-Based Study. Neuroepidemiology. 2019; 52: 227–236

    Not in our library10.1159/000499070

  56. 56.

    Guler S, Caylan A, Turan FN, Dagdeviren N. The prevalence of essential tremor in Edirne and its counties accompanied comorbid conditions. Neurol Res. 2019; 41: 847–856

    Not in our library10.1080/01616412.2019.1628409

  57. 57.

    Sun H, Sun F, Zhang XQ, Fang XH, Chan P. The Prevalence and Clinical Characteristics of Essential Tremor in Elderly Chineses: A Population-Based Study. J Nutr Health Aging. 2020; 24: 1061–1065

    Not in our library10.1007/s12603-020-1472-7

  58. 58.

    Benito-Leon J, Bermejo-Pareja F, Louis ED. Incidence of essential tremor in three elderly populations of central Spain. Neurology. 2005; 64: 1721–1725

    Not in our library10.1212/01.wnl.0000161852.70374.01

  59. 59.

    Louis ED, Ford B, Lee H, Andrews H. Does a screening questionnaire for essential tremor agree with the physician’s examination? Neurology. 1998; 50: 1351–1357

    Not in our library10.1212/wnl.50.5.1351

  60. 60.

    Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord. 1998; 13(Suppl 3): 2–23

    Not in our library10.1002/mds.870131303

  61. 61.

    Louis ED. The Roles of Age and Aging in Essential Tremor: An Epidemiological Perspective. Neuroepidemiology. 2019; 52: 111–118

    Not in our library10.1159/000492831

  62. 62.

    Louis ED, Dure LS, Pullman S. Essential tremor in childhood: a series of nineteen cases. Mov Disord. 2001; 16: 921–923

    Not in our library10.1002/mds.1182

  63. 63.

    Louis ED, Fernandez-Alvarez E, Dure LSt, Frucht S, Ford B. Association between male gender and pediatric essential tremor. Mov Disord. 2005; 20: 904–906

    Not in our library10.1002/mds.20483

  64. 64.

    Louis ED, Kuo SH, Tate WJ, Kelly GC, Faust PL. Cerebellar pathology in childhood-onset vs. adult-onset essential tremor. Neurosci Lett. 2017; 659: 69–74

    Not in our library10.1016/j.neulet.2017.08.072

  65. 65.

    Louis ED, Ottman R. Study of possible factors associated with age of onset in essential tremor. Mov Disord. 2006; 21: 1980–1986

    Not in our library10.1002/mds.21102

  66. 66.

    Louis ED, Clark LN, Ottman R. Familial versus Sporadic Essential Tremor: What Patterns Can One Decipher in Age of Onset? Neuroepidemiology. 2015; 44: 166–172

    Not in our library10.1159/000381807

  67. 67.

    Louis ED. Environmental Epidemiology of Essential Tremor. Neuroepidemiology. 2008; 31: 139–149

    Not in our library10.1159/000151523

  68. 68.

    Schrag A, Munchau A, Bhatia KP, Quinn NP, Marsden CD. Essential tremor: an overdiagnosed condition? J Neurol. 2000; 247: 955–959

    Not in our library10.1007/s004150070053

  69. 69.

    Jain S, Lo SE, Louis ED. Common misdiagnosis of a common neurological disorder: how are we misdiagnosing essential tremor? Arch Neurol. 2006; 63: 1100–1104

    Not in our library10.1001/archneur.63.8.1100

  70. 70.

    Amlang CJ, Trujillo Diaz D, Louis ED. Essential Tremor as a “Waste Basket” Diagnosis: Diagnosing Essential Tremor Remains a Challenge. Front Neurol. 2020; 11: 172

    Not in our library10.3389/fneur.2020.00172

  71. 71.

    Louis ED, Meyers JH, Cristal AD, et al. Transient, Isolated Head Tremor in “Unaffected” Individuals: Is Essential Tremor an Even More Prevalent Disease Than We Suppose? Front Neurol. 2018; 9: 570

    Not in our library10.3389/fneur.2018.00570

  72. 72.

    Louis ED, Badejo FM, Cristal AD, et al. Early Head Tremor in Essential Tremor: A Case Series and Commentary. Tremor Other Hyperkinet Mov (N Y). 2017; 7: 453

    Not in our library10.5334/tohm.340

  73. 73.

    Hening WA, Allen RP, Washburn M, Lesage SR, Earley CJ. The four diagnostic criteria for Restless Legs Syndrome are unable to exclude confounding conditions (“mimics”). Sleep Med. 2009; 10: 976–981

    Not in our library10.1016/j.sleep.2008.09.015

  74. 74.

    Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003; 4: 101–119

    Not in our library10.1016/s1389-9457(03)00010-8

  75. 75.

    Yeh P, Walters AS, Tsuang JW. Restless legs syndrome: a comprehensive overview on its epidemiology, risk factors, and treatment. Sleep Breath. 2012; 16: 987–1007

    Not in our library10.1007/s11325-011-0606-x

  76. 76.

    Hirtz D, Thurman DJ, Gwinn-Hardy K, Mohamed M, Chaudhuri AR, Zalutsky R. How common are the “common” neurologic disorders? Neurology. 2007; 68: 326–337

    Not in our library10.1212/01.wnl.0000252807.38124.a3

  77. 77.

    Louis ED, Kerridge CA, Chatterjee D, et al. Contextualizing the pathology in the essential tremor cerebellar cortex: a patholog-omics approach. Acta Neuropathol. 2019; 138: 859–876

    Not in our library10.1007/s00401-019-02043-7

  78. 78.

    Louis ED, Faust PL. Essential tremor pathology: neurodegeneration and reorganization of neuronal connections. Nat Rev Neurol. 2020; 16: 69–83

    Not in our library10.1038/s41582-019-0302-1

Reads

Read by people on this page

None yet.

Checked or read by AI through naulon

None yet.

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.

Are you an author?

Is this your paper?

Claim it to add your note and be paid when agents cite it. Free.