Objective: To identify the prevalence of delirium in inpatients with Parkinson’s disease (PD).

Background: People with PD may be at increased risk of delirium and associated adverse outcomes, such as cognitive decline and increased mortality. Delirium is an acute neuropsychiatric syndrome associated with altered levels of consciousness, confusion and impaired attention. Previous studies may have underestimated the prevalence of delirium in due to poorly defined criteria and not addressing overlapping symptoms with PD and PD dementia. It is important to understand the prevalence of delirium and identify patients who may be at increased risk of delirium.

Method: Over four-months, people with PD admitted to hospitals in Newcastle upon Tyne were invited to take part. Delirium point prevalent was classified using a standardised assessment at a single visit based on Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) criteria. Frailty was measured using the Clinical Frailty Scale. To capture their remaining time in hospital, incident delirium was diagnosed using detailed clinical vignettes compiled from participants’ medical notes and a validated consensus method.

Results: We screened 127 admissions; n=44 patients consented to take part in the study, accounting for 53 admissions. Forty-eight (90.6%) were emergency admissions. The admitting team screened 24.5% admissions for delirium and identified three cases. The point prevalence of delirium using the DSM-5 assessment identified delirium in 34.0% (n=18) of admissions a mean of 39.7±30.7 hours after admission. Reviewing participants over the duration of their hospital stay using the consensus method identified 30 (56.6%) incident delirium cases. Cases with delirium were significantly older, had higher frailty scores, higher C-reactive protein concentrations and a longer hospital stay (p<0.05 for all).

Conclusion: We found that delirium was common in inpatients with PD, although less than a quarter of admissions had a delirium screening by the admitting team. Participants with delirium were older, frailer and spent longer in hospital. As delirium occurred in more than half of cases and is associated with poor outcomes, our results highlight the importance of screening for delirium throughout patients’ stay in hospital. Future studies should consider multiple visits over the duration of hospital stay to identify delirium that develops during the admission.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/identifying-delirium-in-people-with-parkinsons-disease-the-determine-pd-pilot-study/