Treatment of Restless Legs Syndrome (RLS) in Older Adults

Treatment of Restless Legs Syndrome (RLS) in Older Adults - #79

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Diagnosis and management of restless legs syndrome in a geriatric patient.

List treatment strategies for restless legs syndrome and choose an appropriate medication strategy for an individual patient.

Restless legs syndrome is also known as Willis-Ekbom disease (WED). The definition of RLS is “feelings of restlessness and paresthesia-like sensations in the lower legs while at rest that transiently improve with movement”.  Symptoms are worse at night, as they typically follow a circadian rhythm and older persons typically present with insomnia complaints as a result. 1,5 Primary RLS represents a familial relationship and is generally diagnosed before age 40. Secondary RLS is more common in older adults and is most often associated with other age-related illnesses.

  1. Define restless legs syndrome and its frequent coexistence with other age-related illnesses.
  2. Identify strategies for treating restless legs syndrome in a geriatric patient.
  1. Garcia-Borreguero D, Cano-Pumarega I. New concepts in the management of restless legs syndrome. BMJ. 2017;356:j104.
  2. Bertisch S. In the Clinic: Restless Legs Syndrome. Ann of Internal Med. 2015.
  3. Trenkwalder C, Allen R, Hogl B, et al. Restless legs syndrome associated with major diseases: A systematic review and new concept. Neurology. 2016;86:1336-134
  4. Anguelova GV, Vlak MHM, Kurvers AGY, and Rijsman RM. Pharmacologic and Nonpharmacologic Treatment of Restless Legs Syndrome. Sleep Med Clin. 13 (2018) 219-230.
  5. Miner B, Gill TM, Yaggi HK, et al. Insomnia in Community-Living Persons with Advanced Age. J Am Geriatr Soc. 2018 May 21. [Epub ahead of print].
This GFF ___ my competence in geriatrics.

Mollie Sloot, PharmD, PGY2 Ambulatory Care Pharmacy Resident (Pain Management Focus), Wm. S. Middleton Memorial VA Hospital, Clinical Instructor; Pharmacy, University of Wisconsin School of Medicine and Public Health

Steven Barczi, MD, Madison VA Geriatrics Research, Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Professor of Medicine; Division of Geriatric Medicine, University of Wisconsin School of Medicine and Public Health