Objective: To report delirium prevalence in hospitalised Parkinson’s disease (PD) participants compared to older adults and examine the association with mortality in a prospective study.

Background: Parkinson’s disease (PD) is a risk factor for delirium but reported inpatient prevalence varies widely across the literature and is often underreported. Delirium in general older populations can lead to detrimental outcomes such as increased mortality risk, dementia, and institutionalisation, although to date there are no comprehensive prospective studies in PD.

Method: Participants were from the ‘Defining Delirium and its Impact in Parkinson’s Disease’ (DELIRIUM-PD) and the ‘Delirium and Cognitive Impact in Dementia’ (DECIDE) studies. People with PD (DELIRIUM-PD) or older adults from the Cognitive Function and Ageing Study II – Newcastle cohort (DECIDE) admitted to the Newcastle Upon Tyne Hospital Trust were approached to take part.  Delirium was classified prospectively using the Diagnostic and Statistical Manual of Mental Disorders – 5^th Edition criteria which takes account of observations, standardised testing and collateral history from informants and hospital staff.  Date of death was determined by medical note reviews approximately 12 months post hospital discharge.

Results: Participants comprised 121 PD participants and 199 older adult controls. Delirium was identified in 38.7% of the controls compared to 66.9% of PD participants (p<.001). In PD, mortality was significantly higher in participants with delirium compared to those without delirium (46.9% vs. 15%, respectively, p<.001). PD participants with delirium had a significantly lower survival probability at approximately 12 months post hospital discharge compared to those without delirium (53.7% vs. 85%, respectively, p<.001) and controls with delirium (71.1%, p=.025). The hazard of mortality in PD participants, after one year was increased by delirium (HR=3.3 [95% CI 1.3-8.6], p=.014) independent of age, sex, clinical frailty, and dementia.

Conclusion: Delirium is more common in inpatients with PD compared to older adults without PD, with over half experiencing a delirium episode. People with PD who experience a delirium episode have an increased risk of mortality within a year of hospital discharge. Further research is essential to accurately identify delirium and thus intervene to potentially prevent it in the PD population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-prevalence-of-delirium-and-subsequent-outcomes-in-inpatients-with-parkinsons-disease/