Causes of Shaking Hands After 55
For many people, the onset of hand tremors after age 55 can be startling. While it is not an inevitable part of aging, several conditions and factors become more prevalent in this stage of life. It is important to differentiate between temporary shaking and chronic conditions, and to recognize when medical attention is necessary.
Essential Tremor: The Most Common Culprit
Essential Tremor (ET) is a neurological disorder and is considered the most common cause of tremors. Unlike other conditions, ET is typically an 'action tremor,' meaning the shaking occurs primarily when a person is attempting to use their hands, such as when writing, drinking, or holding an object. Key characteristics include:
- Shaking that happens during voluntary movement.
- It often affects both sides of the body equally.
- Symptoms can progress slowly over time.
- It can also affect the head, voice, or legs.
- Stress, fatigue, and caffeine intake can worsen the tremor.
While not life-threatening, ET can significantly impact a person's quality of life. Diagnosis is made by a healthcare professional after ruling out other potential causes. The exact cause is unknown, but genetics play a significant role, with many people reporting a family history of the condition.
Parkinson's Disease: A Key Distinction
Parkinson's disease (PD) is another neurological disorder that can cause tremors, but it has a distinct presentation from ET. While a less common cause than ET, it is a crucial consideration. A hallmark of PD is the 'resting tremor'—shaking that occurs when the hands are at rest and not engaged in an activity. Other differentiating factors include:
- The tremor often starts on one side of the body and may eventually spread.
- It is accompanied by other motor symptoms like stiffness, slowed movement (bradykinesia), and balance problems.
- Unlike ET, the tremor may decrease or stop when the hand is used purposefully.
- As a progressive disorder, symptoms worsen over time.
Other Medical Conditions
Beyond the most common neurological disorders, several other health conditions can contribute to or cause hand tremors. These include:
- Hyperthyroidism: An overactive thyroid gland can increase metabolism and cause tremors, among other symptoms.
- Multiple Sclerosis (MS): Damage to the nerves in the brain and spinal cord can lead to a variety of symptoms, including tremors.
- Stroke: Damage to certain parts of the brain, particularly the thalamus or basal ganglia, can cause tremors.
- Vitamin Deficiency: Deficiencies in vitamins crucial for nerve function, particularly B12, can manifest as tremors.
- Liver or Kidney Disease: These conditions can lead to tremors due to metabolic imbalances.
Lifestyle and Environmental Factors
Sometimes, shaky hands are a temporary and reversible phenomenon caused by lifestyle factors. For older adults, who may be more sensitive to these effects, they can be particularly noticeable.
- Excessive Caffeine Intake: As a stimulant, caffeine can make existing tremors worse or cause temporary shakiness.
- Stress and Anxiety: A 'fight-or-flight' response releases adrenaline, which can cause muscles to tense and shake. Chronic anxiety can also lead to psychogenic tremors.
- Fatigue and Lack of Sleep: When the body is tired, a physiological tremor can become more pronounced.
- Alcohol Withdrawal: In individuals with alcohol use disorder, withdrawal can cause significant tremors.
The Role of Medication
Certain medications commonly prescribed to older adults can have tremors as a side effect. It is essential to discuss your complete medication list with a doctor if new or worsening tremors appear. Some culprits include:
- Bronchodilators for asthma
- Antidepressants and mood stabilizers
- Corticosteroids
- Anti-seizure medications
- Immunosuppressants
Essential Tremor vs. Parkinson's Disease: A Comparison
To help clarify the differences between the two most common causes, this table provides a side-by-side comparison. Keep in mind that a medical diagnosis is required to confirm the cause of your tremor.
| Feature | Essential Tremor (ET) | Parkinson's Disease (PD) |
|---|---|---|
| Onset | Gradually over time, often after age 40 | Gradually over time, often after age 60 |
| Timing of Tremor | An 'action' tremor, most noticeable during movement | A 'resting' tremor, most noticeable when at rest |
| Location of Tremor | Primarily hands, but can affect head, voice, and legs | Often starts unilaterally in one hand; may affect legs, jaw |
| Additional Symptoms | Can affect balance in severe cases; primarily a tremor disorder | Accompanied by stiffness, slowed movement, and balance issues |
| Progression | Typically slowly progressive; may not shorten lifespan | Progressive, with symptoms worsening over time |
Diagnosis and Management
Accurate diagnosis is the first step toward effective management. A neurologist specializing in movement disorders can provide the most accurate assessment. The diagnostic process often involves a detailed medical history, a physical exam, and sometimes blood tests to check for underlying conditions like thyroid issues or vitamin deficiencies. Imaging scans like a DaTscan may be used to distinguish between ET and PD.
When to See a Doctor It is important to seek medical advice if your tremor is:
- Prolonged or severe enough to interfere with daily activities.
- Accompanied by other symptoms like stiffness, walking difficulties, or changes in thinking.
- Worsening over time.
- Causing emotional distress or social anxiety.
Management and Coping Strategies While some tremors require medication, many can be managed with lifestyle adjustments and therapies. Always consult a professional before making changes.
- Limit Stimulants: Reduce or eliminate caffeine, nicotine, and other stimulants from your diet.
- Reduce Stress: Practice relaxation techniques such as deep breathing, meditation, or yoga.
- Physical and Occupational Therapy: A therapist can help with exercises to improve muscle strength, control, and coordination. They may also recommend adaptive tools.
- Lifestyle Changes: Use adaptive equipment like weighted utensils, heavier glasses, or larger writing tools to manage daily tasks.
- Surgical Options: For severe, disabling tremors that don't respond to medication, procedures like deep brain stimulation (DBS) may be considered.
Conclusion
Hand tremors after the age of 55 are a relatively common occurrence, but they are not a problem to be ignored. While Essential Tremor is the most likely cause, it is critical to get a professional diagnosis to rule out more serious conditions like Parkinson's disease or other medical issues. Management strategies range from simple lifestyle modifications to medication or therapy. By understanding the potential reasons behind the shaking and seeking proper medical guidance, you can effectively manage the symptoms and maintain your quality of life. For further information on neurological disorders, consider consulting a trusted resource like the National Institute of Neurological Disorders and Stroke.
