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Restless legs syndrome

A community-based study of prevalence, severity, and risk factors

From the Department of Neurology (Drs. Högl, Kiechl, Willeit, Saletu, Frauscher, Seppi, Müller, Wenning, and Poewe), Innsbruck Medical University, Austria; and Department of Neurology (Drs. Rungger and Gasperi), Bruneck Medical Hospital, Bruneck, Italy.

Address correspondence and reprint requests to Dr. Werner Poewe, Department of Neurology, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria; e-mail: werner.poewe{at}uibk.ac.at

Objective: To assess the prevalence and severity of restless legs syndrome (RLS) in the general community and to investigate its potential relationship with iron metabolism and other potential risk factors.

Methods: This was a cross-sectional study of a sex- and age-stratified random sample of the general population (50 to 89 years; n = 701). The diagnosis of RLS was established by face-to-face interviews; severity was graded on the RLS severity scale. Each subject underwent a thorough clinical examination and extensive laboratory testing.

Results: The prevalence of RLS was 10.6% (14.2% in women, 6.6% in men); 33.8% of all patients with RLS had mild, 44.6% had moderate, and 21.6% had severe disease expression. None had been previously diagnosed or was on dopaminergic therapy. Free serum iron, transferrin, and ferritin concentrations were similar in subjects with and without RLS. However, soluble transferrin receptor (sTR) concentrations were different in subjects with and without RLS (1.48 vs 1.34 mg/L; p < 0.001). Female sex and high sTR independently predicted the risk of RLS.

Conclusion: This large survey confirms the high prevalence, female preponderance, and underrecognition of restless legs syndrome in the general community. Although two-thirds of patients had moderate to severe disease, none was on current dopaminergic therapy.

The Bruneck Study was supported by Pustertaler Verein zur Prävention von Herz- und Hirngefaesserkrankungen, Sanitaetseinheit Ost, and Assessorat fuer Gesundheit, Province of Bolzano, Italy.

Received December 21, 2004. Accepted in final form March 2, 2005.

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