What to Look for When Seniors Have Restless Legs

Restless legs syndrome (RLS) is a common sleep-related movement disorder in older people.

As many as 15 percent of all people experience RLS, including younger people. However, most individuals dealing with RLS are over the age of 40, and its prevalence measures in at around 5 percent of people aged 60 years or older.1

When RLS happens in older adults, there might be more to consider beyond the sleep movement disorder.

RLS in older adults

RLS can happen to anyone at any age. It’s usually diagnosed based on the following criteria, in which:2

  • There’s an urgent need to move the legs to find relief from unusual sensations (described as unpleasantly creeping, crawling, burning, or tingling)
  • The urge to move the legs occurs begin or worsen during periods of inactivity
  • The sensations are partially or totally relieved by movement
  • The sensations only occur at night or worsen at night
  • Other conditions or diseases that mimic RLS are ruled out

It’s this last parameter for diagnosing RLS which may have special relevance to seniors. Other conditions commonly experienced by older adults which could mimic RLS include:2

  • Myalgia (nerve pain)
  • Venous stasis (poor blood circulation in the legs)
  • Leg edema (swelling caused by dysfunctional veins or heart failure)
  • Arthritis
  • Leg cramps (due to low magnesium levels, medication side effects, or other health conditions)
  • Positional discomfort (due to other health conditions)

Isn’t low iron the cause for all RLS?

One of the key explanations for RLS is that the person experiencing these problems has iron deficiency or anemia.

Iron deficiency describes a situation where the body doesn’t have enough iron in the bloodstream. Iron provides the necessary structure for the building of red blood cells.

Anemia, on the other hand, describes the body’s shortage of red blood cells.

Up to almost a third of older people with RLS can trace its cause back to iron deficiency.3

However, these common concerns related to iron deficiency and anemia may not always explain certain cases of restless legs in the senior community. For people of a certain age, other reasons for concern exist that relate to something known as comorbidities.

What about RLS comorbidities?

Comorbidities describe other medical conditions which happen in tandem with other medical conditions.

In the case of RLS, other medical comorbidities may also occur simultaneously. These include:4,5

RLS comorbidities and older adults

If an older person complains of RLS and is seeing a doctor for other symptoms, it’s important to keep these other conditions top of mind. There are two reasons for this:

  1. Older people may have multiple or complex conditions that need clarification through accurate diagnoses of comorbidities.
  2. Treatments for these medical conditions can be customized so they don’t exacerbate comorbid conditions or introduce undesirable drug interactions.6

Some common medications used to treat medical conditions in our older community, which could exacerbate RLS, include:7

  • Antihistamines
  • SSRIs (selective serotonin reuptake inhibitors)
  • Beta blockers

If you or a loved one deals nightly with the unpleasant sensations linked to RLS, it’s important to see a doctor to get a differential diagnosis or to screen for other possible comorbid conditions that may also need treating.

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