title: Symptoms of restless legs syndrome in older adults: outcomes on sleep quality, sleepiness, fatigue, depression, and quality of life.
abstract: OBJECTIVE
  To compare differences in sleep quality, sleepiness, fatigue, depression, and quality of life according to severity of symptoms of restless legs syndrome (RLS) in older adults.
  
  
  METHODS
  Descriptive, comparative study; cross-sectional design.
  
  
  METHODS
  Penn Sleep Center at the University of Pennsylvania and RLS support groups in Philadelphia.
  
  
  METHODS
  Thirty-nine adults, aged 65 and older, diagnosed with RLS with symptoms at least 3 nights per week. Participants were stratified according to symptom severity based on scores from the RLS Symptom Severity Scale. Exclusion criteria were dementia, cognitive impairments, and sleep disorders other than RLS.
  
  
  METHODS
  Sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), was the primary outcome. Secondary outcomes were sleepiness, fatigue, depression, and quality of life measured using the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Center for Epidemiological Studies--Depression Scale (CES-D), and RLS Quality of Life Instrument (RLS-QLI), respectively.
  
  
  RESULTS
  Significant differences were found in subjective sleep quality (P=.007) and sleep duration (P=.04), as well as in PSQI global score (P=.007). RLS-QLI sleep quality (beta=-0.12, 95% confidence interval (CI)=-0.18 to -0.06, P<.001) and sleepiness (beta=0.35, 95% CI=0.09-0.61, P=.01) were significantly related to PSQI global score. Subjects with severe symptoms were five times as likely to use medication to treat RLS (OR=5.3, 95% CI=1.2-22.2).
  
  
  CONCLUSIONS
  The severity of RLS symptoms in older adults affects not only sleep quality but also many aspects of quality of life, including social functioning, daily functioning, and emotional well-being.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. ncuellar@nursing.upenn.edu
authors.forename: Norma G
authors.initials: NG
authors.lastname: Cuellar
authors.forename: Neville E
authors.initials: NE
authors.lastname: Strumpf
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000523:psychology; D005221:Fatigue / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D014481:United States / Q000453:epidemiology