Prevalence and Determinants of Restless Legs Syndrome (Willis-Ekbom Disease) in an Older Greek Population

Abstract

ABSTRACT Objectives The present study aimed to explore the descriptive and analytic epidemiology of restless legs syndrome (RLS) in the older Greek population, with a specific focus on lifestyle indicators. Methods Baseline data from the randomly selected non-demented older participants of the population-based HELIAD cohort were analyzed. Multivariable binary logistic regression with RLS diagnosis as the dichotomous dependent outcome was performed. Demographic, socioeconomic, anthropometric, dietary, sleep-related and psychological parameters, physical activity, use of psychoactive substances and personal medical history were investigated for potential associations. Results A total of 133 from the eligible sample of 1,838 participants were diagnosed with RLS. The mean age-sex standardized prevalence of RLS among the elderly was estimated at 6.1% (95%CI = 5.0–7.2), with a female (8.0%, 95%CI = 6.4–9.6) to male (3.7%, 95%CI = 2.4–5.1) ratio of 2.1. The prevalence of RLS peaked during the 8th decade of life and diminished thereafter. The positive associations of RLS with female sex [OR = 2.06, 95%CI = (1.19–3.57)], anxiety levels [assessed by the 22-point HADS scale, OR = 1.08, 95%CI = (1.03–1.13)] and traumatic brain injury [OR = 2.22, 95%CI = (1.37–3.62)] were reproduced. Good sleep quality was related to 55% [95%CI~(24–83%)] lower odds of having RLS in comparison with both poor and moderate quality. Adherence to the Mediterranean dietary pattern [assessed by a 55-point scale, OR = 1.06, 95%CI = (1.01–1.11)], and low daily energy intake [low-moderate vs. low: OR = 0.45, 95%CI = (0.26–0.79)]; [moderate-high vs. low: OR = 0.69, 95%CI = (0.40–1.22)]; [high vs. low: OR = 0.31, 95%CI = (0.13–0.69)] were related to RLS for the first time. Conclusions More emphasis should be placed on the dietary-nutritional aspects of RLS.