What Causes Shaking Hands in Old Age?

The ten major causes of shaky hands in older people include:

• Parkinson’s disease: Mostly seen in people older than 60 years although it can begin earlier. Older people with Parkinson's disease may experience poor muscle control, involuntary movements, and reduced life expectancy. It is estimated that about one percent of people older than 60 years have Parkinson's disease.
• Multiple sclerosis: Damages the myelin sheath (protective sheath) that covers the nerves in your brain and spinal cord. Tremors are caused by damage to the cerebellum. The cerebellum helps coordinate movement and controls your balance.
• Stroke: A medical emergency in which the blood supply to a particular part of the brain is hampered. Shaky hands following a stroke are usually seen when the thalamus or basal ganglia are affected.
• Any trauma to the brain: Post-traumatic brain tremors occur when a particular part of the brain that helps in movement gets damaged. Tremors due to brain trauma are not very common.
• Hypoglycemia (low blood sugar level): Often results in tremors, sweating, hunger, and anxiety, as it triggers the release of the hormones epinephrine and norepinephrine.
• Huntington's disease: An inherited disease that reduces life expectancy and hampers brain function. Symptoms of the disease are mostly seen between people aged 30 and 50 years. Symptoms include involuntary movements of the hands, legs, head, face, and upper body. Huntington's disease may lead to a decline in thinking and reasoning abilities.
• Anxiety: One of the reasons for tremors in older people. When you have anxiety, the body reacts to danger, causing muscle twitching or shaking. These tremors are known as psychogenic tremors.
• Medications that cause tremors: Few medicines that are prescribed for treating other health conditions may cause tremors, such as:
  • Hypertension drugs
  • Antiviral drugs
  • Antibiotics
  • Antidepressants
  • Stimulants
  • Immunosuppressants
  • Asthma medicines
  • Antiepileptic drugs
  • Cancer treatments
• Stress: Tremors are not always caused by diseases. Any type of stress, such as that related to finances, health, work, sleep deprivation, and other stress, may be the reason for shaky hands. 
• Vitamin B12 deficiency: Vitamin B12 helps maintain healthy nerves. A deficiency of vitamin B12 may cause tremors. The doctor may prescribe you vitamin B12 shots. Foods such as meat, fish, poultry, eggs, and milk products are rich in vitamin B12.

The tremors can be categorized into three types:

1. Intention tremors: At rest, there will be no tremors. These types of tremors occur when you grasp or try to reach something. These tremors cause difficulty in performing daily activities.
2. Postural tremors: Occur when in a particular position, such as standing or sitting but not in the lying position.
3. Resting tremors: Occur even when the muscles are relaxed such as when the hands are resting on the lap.

The treatment of tremors depends on their cause. If underlying conditions are the cause of the tremors, treating the condition may reduce or even eliminate your symptoms.

Medication for shaky hands

• Primidone and propranolol are medicines that are often used to treat tremors
• Topiramate and gabapentin are anit-seizure medications that are sometimes used to treat tremors
• Botulinum toxin (Botox) injections have been shown to ease tremors

Lifestyle changes

• Avoid caffeine and alcohol
• Utilize relaxation techniques, such as yoga, to reduce stress
• Stop taking medications that cause tremors as per your doctor’s recommendations

Surgical treatment

• In severe cases, a stimulating device may be surgically implanted in your brain