Delirium is more common and associated with worse outcomes in Parkinson's disease compared to older adult controls: results of two prospective longitudinal cohort studies.

Journal: Age and ageing

Volume: 53

Issue: 3

Year of Publication: 2024

Affiliated Institutions:  Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK. MRC Unit for Lifelong Health and Ageing, University College London, London, UK. Institute of Mental Health, School of Medicine, Nottingham University, Nottingham, UK. Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. Department of Psychiatry, University of Cambridge, Cambridge, UK. Department of Neurological Sciences, Rush University Medical Center, Chicago, USA. Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK.

Abstract summary 

Inpatient prevalence of Parkinson's disease (PD) delirium varies widely across the literature. Delirium in general older populations is associated with adverse outcomes, such as increased mortality, dementia, and institutionalisation. However, to date there are no comprehensive prospective studies in PD delirium. This study aimed to determine delirium prevalence in hospitalised PD participants and the association with adverse outcomes, compared to a control group of older adults without PD.Participants were hospitalised inpatients from the 'Defining Delirium and its Impact in Parkinson's Disease' and the 'Delirium and Cognitive Impact in Dementia' studies comprising 121 PD participants and 199 older adult controls. Delirium was diagnosed prospectively using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria. Outcomes were determined by medical note reviews and/or home visits 12 months post hospital discharge.Delirium was identified in 66.9% of PD participants compared to 38.7% of controls (p < 0.001). In PD participants only, delirium was associated with a significantly higher risk of mortality (HR = 3.3 (95% confidence interval [CI] = 1.3-8.6), p = 0.014) and institutionalisation (OR = 10.7 (95% CI = 2.1-54.6), p = 0.004) 12 months post-discharge, compared to older adult controls. However, delirium was associated with an increased risk of developing dementia 12 months post-discharge in both PD participants (OR = 6.1 (95% CI = 1.3-29.5), p = 0.024) and in controls (OR = 13.4 (95% CI = 2.5-72.6), p = 0.003).Delirium is common in hospitalised PD patients, affecting two thirds of patients, and is associated with increased mortality, institutionalisation, and dementia. Further research is essential to understand how to accurately identify, prevent and manage delirium in people with PD who are in hospital.

Authors & Co-authors:  Gerakios Yarnall Bate Wright Davis Stephan Robinson Brayne Stebbins Taylor Burn Allan Richardson Lawson

Study Outcome 

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Statistics
Citations :  Wilson JE, Mart MF, Cunningham Cet al. . Delirium. Nat Rev Dis Primers 2020; 6: 90.
Authors :  14
Identifiers
Doi : afae046
SSN : 1468-2834
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Delirium;Institutionalisation;Mortality;Older people;Outcomes;Parkinson's disease
Study Design
Study Approach
Country of Study
Publication Country
England