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Green S, Perrott SL, McCleary A, et al. First delirium episode in Parkinson's disease and parkinsonism: incidence, predictors, and outcomes. NPJ Parkinsons Dis. 2021;7(1):92doi: 10.1038/s41531-021-00234-2.
Green, S., Perrott, S. L., McCleary, A., Sleeman, I., Maple-Grødem, J., Counsell, C. E., & Macleod, A. D. (2021). First delirium episode in Parkinson's disease and parkinsonism: incidence, predictors, and outcomes. NPJ Parkinson's disease, 7(1), 92. https://doi.org/10.1038/s41531-021-00234-2
Green, Samantha, et al. "First delirium episode in Parkinson's disease and parkinsonism: incidence, predictors, and outcomes." NPJ Parkinson's disease vol. 7,1 (2021): 92. doi: https://doi.org/10.1038/s41531-021-00234-2
Green S, Perrott SL, McCleary A, Sleeman I, Maple-Grødem J, Counsell CE, Macleod AD. First delirium episode in Parkinson's disease and parkinsonism: incidence, predictors, and outcomes. NPJ Parkinsons Dis. 2021 Oct 11;7(1):92. doi: 10.1038/s41531-021-00234-2. PMID: 34635668; PMCID: PMC8505483.
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NPJ Parkinsons Dis. 2021 Oct 11;7(1):92. doi: 10.1038/s41531-021-00234-2.

First delirium episode in Parkinson's disease and parkinsonism: incidence, predictors, and outcomes.

NPJ Parkinson's disease

Samantha Green, Sarah L Perrott, Andrew McCleary, Isobel Sleeman, Jodi Maple-Grødem, Carl E Counsell, Angus D Macleod

Affiliations

  1. Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
  2. Ninewells Hospital, Dundee, UK.
  3. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway.
  4. Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway.
  5. Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK. [email protected].

PMID: 34635668 PMCID: PMC8505483 DOI: 10.1038/s41531-021-00234-2

Abstract

To define the incidence, predictors and prognosis of the first hospital delirium episode in Parkinson's disease (PD) and atypical parkinsonism (AP), we identified the first hospital episode of delirium after diagnosis in the Parkinsonism Incidence in North-East Scotland (PINE) study, a prospective community-based incidence cohort of parkinsonism, using chart-based criteria to define delirium. Of 296 patients (189=PD, 107=AP [dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, vascular parkinsonism]), 152 developed delirium (PD = 98, AP = 54). Incidence of first hospital delirium episode per 100 person years was 8.1 (95% confidence interval [CI] 6.6-9.9) in PD and 18.5 (95% CI 13.9-24.7) in AP. Independent predictors of delirium were atypical parkinsonism (Hazard ratio [HR] vs PD = 2.83 [95% CI 1.60-5.03], age in PD but not in AP (HR for 10-year increase 2.29 [95% CI 1.74-3.02]), baseline MMSE (HR = 0.94 [95% CI 0.89-0.99]), APOE ε4 in PD (HR 2.16 [95% CI 1.15-4.08]), and MAPT H1/H1 in PD (HR 2.08 [95% CI 1.08-4.00]). Hazards of dementia and death after delirium vs before delirium were increased (dementia: HR = 6.93 [95% CI 4.18-11.48] in parkinsonism; death: HR = 3.76 [95% CI 2.65-5.35] in PD, 1.59 [95% CI 1.04-2.42] in AP). Delirium is a common non-motor feature of PD and AP and is associated with increased hazards of dementia and mortality. Whether interventions for early identification and treatment improve outcomes requires investigation.

© 2021. The Author(s).

References

  1. Neurology. 1996 Jul;47(1):1-9 - PubMed
  2. PLoS One. 2014 Nov 04;9(11):e111823 - PubMed
  3. Age Ageing. 2006 Jul;35(4):350-64 - PubMed
  4. J Am Geriatr Soc. 2018 Oct;66(10):2022-2030 - PubMed
  5. Parkinsonism Relat Disord. 2013 May;19(5):515-21 - PubMed
  6. Parkinsonism Relat Disord. 2005 Sep;11(6):387-92 - PubMed
  7. JAMA Neurol. 2020 Nov 1;77(11):1373-1381 - PubMed
  8. Neurology. 2008 Aug 26;71(9):670-6 - PubMed
  9. J Neuropsychiatry Clin Neurosci. 2019 Fall;31(4):298-305 - PubMed
  10. J Neural Transm (Vienna). 2009 Nov;116(11):1509-12 - PubMed
  11. Cochrane Database Syst Rev. 2018 Jun 28;6:CD012494 - PubMed
  12. J Neurol Neurosurg Psychiatry. 2013 Nov;84(11):1258-64 - PubMed
  13. Alzheimer Dis Assoc Disord. 1997 Mar;11(1):16-20 - PubMed
  14. Age Ageing. 2014 May;43(3):326-33 - PubMed
  15. J Clin Neurosci. 2014 Jul;21(7):1192-5 - PubMed
  16. J Chronic Dis. 1987;40(5):373-83 - PubMed
  17. Mov Disord. 2006 Jul;21(7):976-82 - PubMed
  18. Psychiatr Genet. 2016 Apr;26(2):53-9 - PubMed
  19. Mov Disord. 2005 Sep;20(9):1104-8 - PubMed
  20. J Neurol. 2015 Nov;262(11):2401-10 - PubMed
  21. Alzheimers Dement. 2018 Oct;14(10):1293-1301 - PubMed
  22. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4 - PubMed
  23. Cochrane Database Syst Rev. 2018 Jun 18;6:CD005594 - PubMed
  24. Brain. 2012 Sep;135(Pt 9):2809-16 - PubMed
  25. Alzheimers Dement. 2020 Mar;16(3):572-580 - PubMed
  26. Neurology. 2005 Dec 27;65(12):1863-72 - PubMed
  27. J Clin Nurs. 2020 Jul;29(13-14):2083-2092 - PubMed
  28. Neurology. 2009 May 5;72(18):1570-5 - PubMed
  29. Int Psychogeriatr. 2013 Nov;25(11):1877-83 - PubMed
  30. J Am Geriatr Soc. 2005 Feb;53(2):312-8 - PubMed
  31. Int J Geriatr Psychiatry. 2012 Jul;27(7):709-15 - PubMed
  32. JAMA Neurol. 2014 Nov;71(11):1405-12 - PubMed
  33. J Geriatr Psychiatry Neurol. 2019 May;32(3):119-136 - PubMed
  34. Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837 - PubMed
  35. Parkinsonism Relat Disord. 2013 Aug;19(8):737-41 - PubMed
  36. Transl Neurodegener. 2016 Jun 01;5:11 - PubMed
  37. Parkinsons Dis. 2018 Oct 14;2018:9497147 - PubMed
  38. Cochrane Database Syst Rev. 2019 Sep 03;9:CD011749 - PubMed
  39. Emerg Med J. 2013 Apr;30(4):263-8 - PubMed
  40. Brain. 2009 Nov;132(Pt 11):2958-69 - PubMed
  41. Ann Neurol. 1995 Nov;38(5):797-808 - PubMed
  42. Parkinsonism Relat Disord. 2016 Nov;32:36-41 - PubMed
  43. Int J Geriatr Psychiatry. 2017 May;32(5):574-581 - PubMed
  44. Int J Geriatr Psychiatry. 2020 May;35(5):547-552 - PubMed

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