What causes body shaking in the elderly? Understanding the reasons behind tremors

While a slight physiological tremor is normal for everyone, about 17% of adults over 64 experience more noticeable tremors. If you're wondering what causes body shaking in the elderly, the answer can range from common, often benign conditions like essential tremor to more serious underlying neurological disorders.

Quick Summary

Body shaking in older adults can stem from common movement disorders like essential tremor, neurological conditions such as Parkinson's disease, or temporary factors like medication side effects, stress, and low blood sugar. Seeking a medical evaluation is crucial for an accurate diagnosis.

Key Points

• Essential Tremor is Common: Essential tremor is the most frequent cause of rhythmic shaking in older adults, typically affecting the hands during movement or posture.

• Resting Tremor Points to Parkinson's: A tremor that occurs when the muscles are at rest and disappears with intentional movement is a key feature of Parkinson's disease.

• Medication is a frequent cause: Many common prescription drugs, including those for asthma, depression, and heart conditions, can cause or worsen tremors as a side effect.

• Stress and Anxiety are Major Triggers: Emotional stress and anxiety can exacerbate or trigger tremors by increasing the body's adrenaline response.

• Other Health Issues Can Play a Role: Metabolic and systemic conditions like hyperthyroidism or low blood sugar (hypoglycemia) can also cause body shaking.

• Medical Evaluation is Essential: Any new or worsening tremor in an older adult should be evaluated by a doctor to determine the underlying cause and ensure proper management.

Common Causes of Body Shaking in the Elderly

Essential Tremor

Essential tremor (ET) is the most common movement disorder and a frequent cause of body shaking in older adults. It is a neurological condition causing involuntary, rhythmic shaking, most often in the hands, but can affect the head, voice, and other body parts. ET typically occurs during movement or when holding a posture, differentiating it from Parkinson's tremors which happen at rest. It can make daily tasks difficult and may worsen with age, stress, fatigue, and caffeine. The condition is often hereditary.

Parkinson's Disease

Parkinson's disease (PD) is another significant cause of tremors in the elderly. The tremor is often a resting tremor, noticeable when the affected body part is at rest. It can resemble a "pill-rolling" motion and may be exacerbated by stress. Early on, it might appear on only one side of the body. PD is also characterized by slowed movement, muscle rigidity, and balance problems.

Medication Side Effects

Many medications can induce or worsen tremors, which is particularly relevant for older adults taking multiple prescriptions. This type of tremor often resolves after adjusting the dosage or stopping the medication.

Some common culprits include psychiatric medications (like lithium and some antidepressants), asthma medications (like albuterol), corticosteroids, certain anti-seizure drugs (like valproic acid), heart medications (like amiodarone), and excessive thyroid medication.

Other Health Conditions and Factors

Various other conditions and lifestyle factors can contribute to body shaking in older adults.

• Hyperthyroidism: An overactive thyroid can cause fine, rapid hand tremors.
• Low Blood Sugar (Hypoglycemia): A drop in blood sugar can cause shakiness, sweating, and anxiety due to adrenaline release.
• Anxiety and Stress: Emotional distress triggers stress hormones, which can cause or worsen tremors, known as psychogenic tremors.
• Alcohol Withdrawal: Discontinuing alcohol in individuals with dependence can cause severe shaking.
• Fatigue and Sleep Deprivation: Being tired can make existing tremors more noticeable.
• Excess Caffeine: High caffeine intake is a stimulant that can induce or worsen tremors.
• Stroke: Damage to certain brain areas, such as the cerebellum, can lead to tremors.

Essential Tremor vs. Parkinson's Disease Tremor

Feature	Essential Tremor (ET)	Parkinson's Disease (PD) Tremor
Timing	Primarily during voluntary action or when holding a posture.	Most noticeable when at rest and diminishes with voluntary movement.
Appearance	Faster, smaller, non-rolling movements.	Often described as a slower, "pill-rolling" motion.
Location	Typically affects both hands and arms, but one side may be worse. Can involve the head, voice, and face.	Usually starts in one hand or leg and may spread to the other side as the disease progresses. May involve the chin or jaw.
Progression	Worsens slowly over many years.	Progressive neurodegenerative disorder with tremor and other motor symptoms.
Associated Symptoms	Primarily just the tremor. Balance issues may occur in advanced stages.	Includes other symptoms like slowness, stiffness, and balance problems.
Response to Alcohol	Small amounts of alcohol can temporarily reduce tremor severity in some individuals.	No effect or can worsen symptoms.

Conclusion

Body shaking in the elderly has various causes, from common conditions like essential tremor and medication side effects to more serious neurological disorders such as Parkinson's disease. While not always serious, any new or worsening tremor should be evaluated by a healthcare professional for accurate diagnosis and management. Identifying the cause is crucial for effective treatment and improving quality of life.

For additional support and information on movement disorders, the National Institute of Neurological Disorders and Stroke is an authoritative resource.

What to Do If an Elderly Person is Shaking

• See a Doctor: A medical evaluation is essential to determine the cause through a physical exam, medication review, and medical history.
• Manage Stress: Since stress can worsen tremors, relaxation techniques like deep breathing or meditation can be helpful.
• Modify Daily Activities: Using adaptive tools like weighted utensils or clothing with Velcro fasteners can make tasks easier.
• Adjust Medications: If medication is the cause, a doctor may adjust the dose or switch to an alternative. Do not stop medication without medical advice.
• Lifestyle Changes: Limiting caffeine and alcohol, getting adequate sleep, and gentle exercise can help reduce tremor severity.

Frequently Asked Questions

What is the most common cause of body shaking in the elderly?

The most common cause of body shaking in older adults is essential tremor, a neurological disorder that causes rhythmic shaking, primarily of the hands and arms, during movement or when holding a static position.

Is all shaking in the elderly a sign of Parkinson's disease?

No, not all shaking in older adults indicates Parkinson's disease. While it is a potential cause, other factors like essential tremor, medication side effects, and anxiety are also very common. A medical evaluation is necessary for an accurate diagnosis.

Can medication cause body shaking in older adults?

Yes, many medications can cause or worsen tremors. Common culprits include psychiatric drugs (like lithium), certain antidepressants, asthma medication, and corticosteroids. The tremor often subsides once the medication is adjusted or discontinued under a doctor's supervision.

How can anxiety cause body shaking in the elderly?

Anxiety and stress trigger the body's "fight or flight" response, releasing adrenaline. This can cause muscles to tense up and tremble, especially in individuals with an existing physiological tremor. This is known as a psychogenic tremor and can be temporary.

What is the difference between an essential tremor and a Parkinson's tremor?

An essential tremor typically occurs during movement or when maintaining a posture, while a Parkinson's tremor is most prominent when the body part is at rest. Additionally, essential tremor is often bilateral, while Parkinson's tremor often starts asymmetrically.

When should an elderly person see a doctor for body shaking?

An elderly person should see a doctor for a tremor if it worsens over time, interferes with daily activities, starts suddenly, or is accompanied by other symptoms like stiffness, weakness, or trouble walking or talking.

What lifestyle changes can help reduce tremors?

Making lifestyle adjustments can help manage tremors. This includes reducing or eliminating caffeine and alcohol, getting sufficient sleep, and practicing relaxation techniques like meditation to manage stress.