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. 2017 Feb 1;40(2):zsw065.
doi: 10.1093/sleep/zsw065.

Association of Restless Legs Syndrome With Incident Parkinson's Disease

Szabolcs Szatmari Jr  1   2   3 , Daniel Bereczki  3   4 , Katalin Fornadi  4 , Kamyar Kalantar-Zadeh  5 , Csaba P Kovesdy  6   7 , Miklos Z Molnar  6   8
Affiliations

Association of Restless Legs Syndrome With Incident Parkinson's Disease

Szabolcs Szatmari Jr et al. Sleep. .

Abstract

Study objectives: The association between restless legs syndrome (RLS) and Parkinson's disease (PD) has been extensively studied with inconclusive results; therefore, we prospectively examined the associations of the presence of RLS with development of incident PD.

Methods: From a nationally representative prospective cohort of almost 3.5 million US veterans (age: 60 ± 14 years, 93% male, median follow-up time of 7.8 years [interquartile range: 6.4-8.4 years]), we created a propensity-matched cohort of 100882 PD-free patients and examined the association between prevalent RLS and incident PD. This association was also assessed in the entire cohort. Associations were examined using Cox models.

Results: There were 68 incident PD events (0.13%, incidence rate 1.87 [1.48-2.37]/10000 patient-years) in the RLS-negative group, and 185 incident PD events (0.37%, incidence rate 4.72 [4.09-5.45]/10000 patient-years) in the RLS-positive group in the propensity-matched cohort. Prevalent RLS was associated with more than twofold higher risk of incident PD (hazard ratio [HR]: 2.57, 95% confidence interval [CI]: 1.95-3.39) compared to RLS-negative patients. Qualitatively similar results were found when we examined the entire 3.5 million cohort: Prevalent RLS was associated with more than twofold higher risk of incident PD (multivariable adjusted HR: 2.81, 95%CI: 2.41-3.27).

Conclusion: RLS and PD share common risk factors. In this large cohort of US veterans, we found that prevalent RLS is associated with higher risk of incident PD during 8 years of follow-up, suggesting that RLS could be an early clinical feature of incident PD.

Keywords: Parkinson’s disease.; restless legs syndrome.

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Figures

Figure 1
Figure 1
Kaplan–Meier curves of incident Parkinson Disease in patients with and without restless legs syndrome in the propensity-matched cohort. Abbreviations: RLS, restless legs syndrome.
Figure 2
Figure 2
Association between restless legs syndrome and incident Parkinson Disease in different subgroups of patients in the propensity-matched cohort. Abbreviations: PD, Parkinson Disease; RLS, restless legs syndrome.
See this image and copyright information in PMC

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