Epidemiology Of Restless Legs Syndrome In The Elderly And The Related Dysfunction Study Of Restless Legs Syndrome

Objectives: 1.To investigate the prevalence of restless legs syndrome(RLS) among elderly population in Dalian and analyze its related risk factors. 2.Explore the relationship among sleep, emotion and cognitive function of RLS.Methods: 1.Investigate the epidemiological and the pre-valence of RLS in the elderly(≥65) in Dalian. We screen-ed out the RLS patient base on RLS diagnostic criteria, then divided them into groups according to ages and the order of severity, com pare the prevalence of different ages and the composition of different severity. And analy-ze the diagnosis and treatment of RLS. Describe the count data with percentage and using x2 test or Fisher’s exact probability method to compare two rate by statistical analysis. 2. Divided 54 RLS patients into groups according to PSQI score, sleep disorder group(SD, PSQI>7)and non-sleep disorder(NSD,PSQI≤7), selected 30 healthy controls as control group match with age, cultural degree, marital status.Evaluated three groups with Hamilton- anxiety scale(HAMA), Hamilton depression(HAMD- 17), Mini-Mental State Examination(MMSE), Montreal cognitive assessment(Mo CA), and compare the difference. SD group and NSD group also need more evaluation with severity RLS questionnaires(RLSRS), then compare the severity of RLS between the two groups. Using the statistical software compared the results, using t test comparison of measurement data, using the linear correlation and regression analysis analyze the relation of PSQI score and severity of RLS, mood, cognitive score.Result: 1.The epidemiological study of elderly RLS in Dalian: 1.1.Age, gender distribution and the prevalence of RLS across all subjects: A total number of Participate in the survey is 966, 524 men and 442 women. 34 people were diagnosed RLS,10 men and 24 women. The total prevalence rate is 3.52%,Male is 1.91% and female is 5.43%.The number of 65-74 age group, 75-84 age group and 85--age groups is 503, 395, 68.RLS prevalence of three age group is 3.18%, 4.05%, 2.94%, Male is: 0.38%, 2.94%,2.43% and female is 5.8%, 5.24%, 3.70%. Statistics analysis: There are Significant differences between women and men in elderly(P<0.05). Significant differences also has found in 65-74 age group between the sexes(P<0.05). The prevalence of 75-75 and85- age groups is no statistical differences between the sexes. There are no statistical difference of the prevalence among different age groups in Elderly RLS(P>0.05). 1.2.The composition of different severity of RLS in all ages: 4 mild(11.76%), 7moderate(20.59%), 23 severe(67.65%) in 34 RLS patients. The number and percentage of mild, moderate and severe in different age group is: 65-74 age group is 2(12.50%),2(12.50%), 12(75.00%), 75-84 age group is 2(12.50%), 4(25.00%), 10(62.50%), 85-age group is 0(0.00%), 1(50.00%), 1(50.00%). Statistics analysis: The severity of different age group RLS constitute no statistical difference(P > 0.05).1.3.The medical history,diagnosed rate and misdiagnosis of the elderly RLS: 34 patients diagnosed with RLS,six people were confirmed the RLS, accounting for 17.60%; six people use drug treatment, accounting for 17.60%. With 2 people take orally Madopar, 2 people take orally Pramipexole Dihydrochloride, the effect is better, 1 person oral Pramipexole Dihydrochloride and clonazepam, the effect is good, 1 person oral clonazepam and Deanxit, the effect is poor. 28 patients have not been confirmed of RLS:12(35.29%)had go to a doctor,Were misdiagnosed as depression, peripheral neuropathy, lower extremity vascular disease, Parkinson’s disease, etc. To the corresponding treatment, but the effect is poor. 16 people(47.06%) feel uncomfortable but Never see a doctor and treatment. The doctors’ office visiting rate was 52.94%, diagnosed rate was 17.60%,treatment rate was 17.60% and the misdiagnosis rate was 35.29% of RLS.2.The sleep, mood, cognitive function assessment of RLS: 2.1.General data comparison:Thee are 35 patients with sleep disorders(SD,64.81%)and 19 patients without disorders(NSD, 35.19%) in 54 RLS patient,30 people in the control group.There are no obvious difference in all aspects with age, education level, marital status, history of trauma among three group(P>0.05). 2.2.The compare of PSQI、HAMA、HAMD、MMSE、Mo CA between case group and control group: The comparison results of case group(SD and NSD) and control group showed: there were significant differences of them(P is0.000 vs. 0.000, 0.001 vs. 0.000, 0.016 vs. 0.000) in PSQI、HAMA、HAMD score. NSD group, the SD group and the control group did not see differences in MMSE score(P >0.05). There were no difference between NSD group and control group in Mo CA, but showed significant difference between SD group and control group. 2.3.The comparison between NSD group and SD group: There were significant differences on RLSRS,HAMA, HDMD score between SD group and NSD group in 54 RLS(P<0.05). The score is 28.54±4.667 vs. 18.11±5.130, 19.88±8.582 vs. 8.79±4.928, 16.34±8.091 vs. 6.63±4.524. There are no statistical differences between two groups on MMSE and Mo CA score(P>0.05). The score is 26.77 ± 3.573 vs. 27.32 ± 4.547, 23.94 ± 4.982 vs.25.84 ± 4.272. 2.4.Correlate and Regression: Using SPSS software to analysis the linear regression between PSQI, RLSRS, HAMA, HAMD, MMSE and Mo CA, we can found a linear correlation among PSQI score, RLSRS and HAMD scores. The r and P is0.494 vs. 0.170, 0.000 vs. 0.012. The regression equation is:++-=170.0494.0393.2HAMDRLSRSPSQI.There is no linear regression relationship among PSQI and HAMA, MMSE, Mo CA(P > 0.05). The r and P is-0.043 vs.0.056 vs.-0.187、0.677 vs. 0.637 vs. 0.259.Conclusion: 1. The prevalence of RLS among elderly in Dalian is 3.52%, male is1.91% and female is 5.43%, women is more predisposition than men. 2. As the growth of the age, the prevalence and severity found no significant change in elderly RLS, Tip the prevalence and severity of RLS was no significant correlation with age increased.3.The doctors’ office visiting rate, diagnosed rate and treatment rate is low, the rate of misdiagnosis and the rate of missed diagnosis is high, the conscious of RLS diagnostic and treatment will be strengthened. 4.RLS patients Are getting sick with sleep disorder,anxiety and depression, sleep disorders increased with the the severity of RLS. 5.RLS of sleep disorders has certain influence to the cognitive function, but without a clear linear correlation. 6.sleep disorders are closely related to RLS severity and depression score in RLS. The linear regression equation among the rating scales is++-=170.0494.0393.2HAMDRLSRSPSQI.