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.

为了确定帕金森病 (PD) 和非典型帕金森病 (AP) 中首次住院谵妄发作的发生率、预测因素和预后，我们确定了苏格兰东北部帕金森病发病率 (PINE) 研究中诊断出的首次住院谵妄发作，一个基于社区的前瞻性帕金森病发病队列，使用基于图表的标准来定义谵妄。在 296 名患者（189 名 = PD，107 名 = AP [路易体痴呆、进行性核上性麻痹、多系统萎缩、血管性帕金森病]）中，152 名出现谵妄（PD = 98，AP = 54）。PD 患者每 100 人年首次住院谵妄发作的发生率为 8.1（95% 置信区间 [CI] 6.6-9.9），AP 患者为 18.5（95% CI 13.9-24.7）。谵妄的独立预测因子是非典型帕金森综合征（危险比 [HR] 与 PD = 2.83 [95% CI 1.60–5.03]，PD 中的APOE ε4（HR 2.16 [95% CI 1.15-4.08]）和PD 中的MAPT H1/H1（HR 2.08 [95% CI 1.08-4.00]）。与谵妄前相比，谵妄后痴呆和死亡的风险增加（痴呆：帕金森病中的 HR = 6.93 [95% CI 4.18-11.48]；PD 中的死亡：HR = 3.76 [95% CI 2.65-5.35]，1.59 [95% CI] 1.04–2.42] 在 AP）。谵妄是 PD 和 AP 的常见非运动特征，与痴呆症和死亡率的风险增加有关。早期识别和治疗的干预措施是否能改善结果需要调查。