Background 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. Methods 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. Results 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). Conclusion 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.

中文翻译：

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与老年人对照相比，帕金森病患者谵妄更为常见，且与较差的预后相关：两项前瞻性纵向队列研究的结果

背景 文献中帕金森病 (PD) 谵妄的住院患病率差异很大。一般老年人群中的谵妄与不良后果相关，例如死亡率增加、痴呆和住院治疗。然而，迄今为止，还没有针对 PD 谵妄的全面前瞻性研究。本研究旨在确定住院帕金森病参与者中谵妄的患病率以及与不良后果的关系，与没有帕金森病的老年人对照组进行比较。方法 参与者是“定义谵妄及其对帕金森病的影响”和“谵妄及其对痴呆症的认知影响”研究的住院患者，包括 121 名帕金森病参与者和 199 名老年人对照。使用《精神疾病诊断和统计手册》第五版标准对谵妄进行前瞻性诊断。结果由出院后 12 个月的医疗记录审查和/或家访确定。结果 PD 参与者中有 66.9% 出现谵妄，而对照组为 38.7%（p < 0.001）。仅在 PD 参与者中，谵妄与显着较高的死亡风险（HR = 3.3（95% 置信区间 [CI] = 1.3–8.6），p = 0.014）和住院治疗风险（OR = 10.7（95% CI = 2.1– 54.6), p = 0.004) 出院后 12 个月，与老年人对照相比。然而，对于 PD 参与者（OR = 6.1（95% CI = 1.3–29.5），p = 0.024）和对照组（OR = 13.4（95% CI = 2.5–72.6), p = 0.003)。结论 谵妄在住院 PD 患者中很常见，影响了三分之二的患者，并且与死亡率增加、住院治疗和痴呆有关。进一步的研究对于了解如何准确识别、预防和管理住院的帕金森病患者的谵妄至关重要。