A Case of Restless Legs Syndrome in the Setting of Long-Term Care and Dementia

Abstract

Restless Legs Syndrome (RLS) is a common disorder that physicians frequently encounter in an outpatient clinic. Within long-term care, there are unique challenges to caring for residents with RLS. An 87-year-old woman with dementia and a history of RLS and nocturnal agitation, resided in a long-term care setting and experienced nighttime agitation and aggression towards staff, coupled with cognitive decline. Her agitation was possibly a result of inadequate treatment of longstanding RLS or worsening of her dementia. On account of her dementia, she was unable to communicate her symptoms. Current diagnostic criteria for RLS require patient reports of subjective symptoms. Patients must describe their feelings within the legs, which helps to clarify the diagnosis. Our case illustrates the difficulty of diagnosing restless legs in patients with dementia and communication difficulties, and the need for empiric treatment.