Why Do Old People Shake? Causes of Elderly Shaking

Medical Reviewer: Dhira Khosla D.O.

Some people might develop a tremor as they get older, although shaking can occur at any age. While trembling is often conflated with Parkinson’s disease, there are many other common causes of shaking, from temporary, benign conditions to side effects of prescription drugs. If you’re an older patient wondering “Why am I shaking?”, follow along as we take a look at some of the causes of tremor in elderly populations. It’s important to note that only your healthcare provider is capable of providing you with a diagnosis and treatment plan for tremors.

Keep reading for a comprehensive explanation or jump to the section relevant to your query.

Tremors, Shaking Hands, and Aging

Sudden, uncontrollable shaking in elderly populations can occur because of benign issues that resolve on their own, or they can be caused by underlying diseases. Not all older adults experience shaking as they age — but if movement disorders run in your family, there’s a higher chance you will develop trembling as well. Age-related tremor is still being studied, but according to the National Center for Biotechnology Information, it is likely a sign of neurodegeneration.

Causes of Tremor and Shaking Hands in the Elderly

What are the causes of hand shaking in elderly populations? Unfortunately, this question can be hard to answer as there are many potential causes of trembling and involuntary movement. In addition, shakiness isn’t just an issue that affects the elderly, you can experience tremors at any age. For example, when you haven’t eaten in a while, your hands may begin to shake due to low blood sugar.

This is just one of the many reasons you may experience tremors and shaking. Below, we’ll explore conditions commonly associated with shaking hands and other tremors in old age.

Essential Tremor

Essential tremor is one of the most common movement disorders, affecting about 5% of the global population. Causing involuntary, rhythmic shaking in the hands, head, voice, torso, or legs, this disorder is most common in those over the age of 65. It can severely impact one’s quality of life, making it difficult to complete important daily tasks such as eating and drinking, and progresses with time.

Although there is no cure, there are therapies and treatments available to manage the symptoms.

Parkinson’s Disease

Parkinson’s disease is found more frequently in people over 60 years of age. In fact, it is one of the most common reasons for hand tremors in elderly populations, with its prevalence doubling in the past 25 years.

Shaking hands associated with Parkinson’s disease are caused by a degeneration of nerve cells in the brain, which in turn results in a deterioration of muscle control and an overall reduction in life expectancy. According to the American Parkinson Disease Association, 80% of Parkinson’s patients experience involuntary movements.

Huntington’s Disease

Huntington’s is an inherited disease that causes a decline of the brain and reduces life expectancy, with symptoms that start between the ages of 30 and 50. In most cases, the disease is characterized by involuntary movement of the arms, legs, head, face, and upper body. It also causes a deterioration in thinking and reasoning.

Multiple Sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disease that impacts the central nervous system, which controls most of our key body functions, from thinking and learning to moving and feeling. In MS, the immune system attacks myelin, the protective layer surrounding our nerves, leaving scar tissue. This damage disrupts the communication between the brain and the body, causing numbness, stiffness, vision problems, shaking hands, and more.

MS can manifest at any age, but it is most common in those aged 20 to 40. If you want to know “Why are my hands shaking?” and suspect MS, speak with a healthcare professional, especially a neurologist, as soon as possible. While there is currently no cure for MS, there are medications and lifestyle changes you can make to manage your symptoms and flare-ups.

Stroke

A stroke is a sudden attack to the brain triggered by a blocked or ruptured artery. It is a medical emergency that can cause brain damage and even result in disability or death. Some signs of stroke include a sudden headache, lack of coordination, blurry vision, confusion, and numbness.

After a stroke, damage sustained to the cerebellum or basal ganglia can result in tremors, especially shaking hands. Luckily, this is a rare occurrence that typically resolves on its own. Within one year, 28% of patients who developed a tremor post-stroke see their shaking resolved, while 64% see it partially resolved.

Cerebral Palsy

Cerebral palsy (CP) is a motor condition that affects one’s movement and muscle tone. While CP symptoms can vary from patient to patient and range in severity, people with CP tend to have stiff muscles, exaggerated reflexes, a lack of balance, and tremors.

In general, CP is developed and diagnosed before the age of 5, but sometimes, a diagnosis later in life is possible as symptoms become more pronounced with age.

Caffeine Toxicity

Caffeine can sometimes induce tremor if you drink too much of it. Besides tremors, you might also experience anxiety, restlessness, agitation, stomach issues, an irregular heartbeat, and insomnia. Drinking caffeine triggers the release of adrenaline, or the “fight or flight” hormone, which can cause shaking.

Pharmaceutical Side Effects

Certain prescribed drugs may result in tremors and shaking hands as a side effect. The most common ones include:

• Epinephrine and norepinephrine
• High blood pressure drugs
• Alcohol
• Antivirals
• Antibiotics
• Antidepressants
• Stimulants
• Mood stabilizers
• Immunosuppressants
• Asthma medication
• Seizure medication
• Cancer treatments

Overactive Thyroid

The signs of an overactive thyroid can be subtle. Millions of people suffer from an overactive thyroid gland, which basically means that your body is in overdrive at all times. Because your nerves are overstimulated, your hands might shake as a result. You might also experience a racing heart, weight loss, insatiable hunger, perspiration, exhaustion, and heat intolerance.

Alcohol Abuse or Withdrawal

Hand tremors can be a symptom of excessive alcohol consumption as well as alcohol withdrawal. These tremors can begin as soon as 10 hours after your last drink and may last for weeks. This is one of the many reasons recovering alcoholics should reduce their alcohol intake only under the guidance of a healthcare provider and addiction specialist. Rehab and detox programs can offer medications to help manage tremors and other signs of alcohol withdrawal.

Hypoglycemia

When your body is hypoglycemic, it means your muscles and nerves are low on their energy source: blood sugar. As a result, your hands may shake. You might also experience symptoms like sweating, hunger, sweating, and anxiety because hypoglycemia triggers the release of hormones like epinephrine and norepinephrine.

Anxiety

Anxiety can be another reason why elderly people shake. If you notice sudden, uncontrollable shaking in elderly relatives, rather than it being an underlying medical condition, they may just be experiencing an anxiety attack.

When you have anxiety, your body is primed to react to danger, which can mean your muscles twitch or shake in response. Anxiety tremors are also known as psychogenic tremors.

Can Sudden Uncontrollable Shaking in the Elderly be Genetic?

Unfortunately, tremors can be passed down genetically. In fact, 50% of all essential tremor cases are thought to be caused by genetic factors.

Scientists and researchers believe essential tremor to be an autosomal dominant trait. If one of your parents has an altered gene for essential tremor, that means you have a 50% chance of developing the disorder as well. Compared to other forms of essential tremor, inherited essential tremor tends to appear earlier in life.

Types of Tremor

The National Institute of Neurological Disorders and Stroke outlines the different types of tremor that can affect tremor patients, from temporary shaking to long term movement disorders.

Action Tremor

Action tremors are often associated with essential tremor. Including postural tremor, isometric tremor, and kinetic tremor, they are a class of tremors that occur with voluntary muscle contraction.

Postural tremor can happen when a person is in a position where a part of their body is working against gravity, like holding out their arms. Kinetic tremor occurs with voluntary actions like reaching for an object or putting a key into a lock. Isometric tremor happens during a voluntary muscle contraction without any additional movement, like holding a book or weight.

Physiologic Tremor

Everyone experiences physiologic tremor. However, you usually won’t notice it because it’s the result of normal human bodily functions. Your muscles naturally pulsate from your heart beating and blood pumping through your body.

Enhanced Physiologic Tremor

Compared to the typical tremor seen in healthy individuals, an enhanced physiological tremor is more noticeable. Instead of being induced from disease, it’s usually a temporary condition resulting from hypoglycemia, alcohol, or a reaction to drugs. It can be reversed once the cause is found.

Cerebellar Tremor

This tremor occurs at the end of a purposeful movement like pressing a button. Usually, the shakiness happens due to damage to the brain after a stroke or other health issues like multiple sclerosis or chronic alcoholism.

Psychogenic Tremor

Psychogenic tremor is brought on by stress, anxiety, depression, or from an underlying psychiatric issue like PTSD. The tremor can affect the hands but may impact all body parts. It increases during stress and can go away when the person is distracted.

Parkinsonian Tremor

Not all people with Parkinson’s disease have a tremor although it’s a common symptom. The tremor usually occurs at rest in one or both hands. Sometimes patients with Parkinson’s disease also experience tremors with movement of their limbs. Shakiness can also be seen in the head, face, or legs. Although it can start on one side of the body, it can spread to both sides as the disease worsens.

Orthostatic Tremor

This tremor is very rare and it’s characterized by very fast shaking that is usually imperceptible by observation alone. In some cases, people with orthostatic tremor feel imbalanced or unsteady. The cause is unknown.

How Does Shaking Affect Older Adults?

As an older adult, if you experience tremors of any kind, you know just how aggravating and bothersome they can be. Not only do they take away your ability to complete basic daily tasks like eating, drinking, walking, and talking with ease, but they also negatively impact your mental health, making you feel discouraged and inadequate. Overall, tremors and shaking decrease your quality of life, putting your independence and agency at stake.

Can Elderly Tremors be Treated?

Although elderly tremors can be hard to manage, depending on the type of tremor you have, there are a variety of treatments available to effectively manage your symptoms. From lifestyle changes to a novel essential tremor therapy, it is crucial to work with your healthcare provider to figure out the best treatment or combination of treatments for you.

Lifestyle Changes

When it comes to managing tremors, making small changes to your lifestyle can make a big difference.

Start with your diet. How can you make your diet more well-balanced? Is there anything you need to cut out for your health and well-being? Caffeine, nicotine, and alcohol increase the severity of tremor symptoms, so it’s best to keep your intake to a minimum.

While you are taking care of your body, remember to take care of your mind as well. Stress and anxiety can make tremors worse. When you are feeling the pressure, what do you do to help ease your mind? Try relaxation exercises such as deep breathing and meditation to mitigate unwanted thoughts. Avoid stressful situations as much as possible as well.

Medication

Medication can be very effective when it comes to relieving essential tremor symptoms. To decrease the frequency and amplitude of tremors, doctors most commonly prescribe beta-blockers, anticonvulsants, tranquilizers, and botox.

However, medication is not for everyone, and it may take trial and error before you find one that works for you. For example, depending on how your body reacts to the medication you are prescribed, you may experience severe side effects or quickly build up a tolerance.

Surgery

Surgery can be the solution if you experience intense, debilitating tremors or if other treatments simply do not work for you. As of now, there are two surgical procedures used to treat essential tremor.

Deep Brain Stimulation (DBS) delivers electrical pulses to certain areas of the brain using a neurostimulation device placed under the collarbone. This helps the brain function more normally and reduces tremor symptoms.

Focused Ultrasound pinpoints the exact location in the brain where tremors originate using magnetic resonance imaging (MRI). Then, it uses high-intensity sound waves with just enough energy to hit the target

In most cases, you’ll need to meet certain criteria to be eligible for these surgeries. Like all surgeries, they come with certain risks and a recovery period.

Cala TAPS therapy

Other than lifestyle changes, medication, and surgery, you can also leverage a novel essential tremor therapy to reduce your symptoms.

Cala TAPS therapy is the world’s only non-invasive, drug-free treatment for essential tremor. Targeting the tremor network in the brain with electrical stimulation known as neuromodulation, the wearable Cala device is safe, effective, and FDA-cleared. It is calibrated to each patient’s unique brain signal pattern and provides temporary hand tremor relief with easy 40-minute sessions.

Many patients experienced a meaningful reduction in tremors using the Cala device. The majority of patients experience tremor relief for over an hour.

Dealing with Tremor in Old Age: Cala TAPS therapy’s Unique Answer

If you’re concerned about tremor or you’re dealing with sudden tremor, you should go to your healthcare provider for proper diagnosis and treatment. For more common movement disorders like essential tremor, there is a novel therapy available to help make symptoms more manageable. Every person’s tremor is unique. Cala TAPS Therapy offers a noninvasive way to manage tremor in the form of a wristband calibrated to the pattern of your shaking.

Although there isn’t a cure for essential tremor, there are many therapies and treatments you can leverage to manage symptoms and enjoy your golden years with less worry.