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Defining delirium in idiopathic Parkinson’s disease: a systematic review

Lookup NU author(s): Dr Rachael LawsonORCiD, Dr Claire McDonald, Professor David Burn



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Background:Parkinson’s disease patients may be at increased risk of delirium and developing adverse outcomes, such as cognitive decline and increased mortality. Delirium is an acute confusional state that has overlapping symptoms with Parkinson’s and dementia, making it difficult to identify. This study aimed to determine the diagnostic criteria, prevalence, management strategies and outcomes of delirium in Parkinson’s through a systematic review of the literature.Methods:Seven databases were used identify all articles published before February 2017 comprising two key terms: “Parkinson’s Disease” and “delirium”. Data were extracted from studies meeting predefined inclusion criteria.Results:Twenty articles were identified. Delirium prevalence in Parkinson’s ranged from 0.3-60% depending on setting; a diagnosis of Parkinson’s was associated with an increased risk of developing delirium. Delirium was identified/diagnosed using seven different criteria. Symptoms included confusion, disorientation, hallucinations and/or delusions, but their frequency was not assessed or reported. Delirium may be associated with an increased length of hospital stay and worsening motor symptoms. We did not identify any studies examining the management of delirium in Parkinson’s. Discussion:This review highlights the paucity of well-designed, appropriately powered studies investigating delirium in Parkinson’s. The results suggest that delirium is a significant issue in people with Parkinson’s and that having delirium may be a risk factor for adverse outcomes, particularly in inpatient settings. Further prospective research is needed to accurately determine the prevalence of delirium in Parkinson’s, its management strategies and outcomes, and to evaluate diagnostic criteria to differentiate between the overlapping symptoms of Parkinson’s and delirium.

Publication metadata

Author(s): Lawson RA, McDonald C, Burn DJ

Publication type: Article

Publication status: Published

Journal: Parkinsonism and Related Disorders

Year: 2019

Volume: 64

Pages: 29-39

Print publication date: 01/07/2019

Online publication date: 29/09/2018

Acceptance date: 21/09/2018

Date deposited: 21/09/2018

ISSN (print): 1353-8020

Publisher: Elsevier


DOI: 10.1016/j.parkreldis.2018.09.025


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