Objective: To determine indicators for hospital admission in patients with Parkinson’s disease (PD) and in patients with Parkinson’s disease Psychosis (PDP), and to compare patients treated with anti-psychotics to those untreated in an incident cohort study in Olmsted County, MN.

Background: Few studies have investigated the risk for hospitalizations among PD and PDP patients and the impact of treatment on hospital admissions.

Method: We used the Rochester Epidemiology Project to define an incident cohort study of parkinsonism from 1991-2010 in Olmsted County, MN. A movement disorder specialist reviewed all the medical records to confirm the diagnoses of PD. We used the NINDS/NIMH unified diagnostic criteria for PDP to differentiate all cases of PDP. A Cox-proportional hazards model was fit using the first record of hospitalization following the onset of PD as the outcome. A secondary analysis implemented a similar Cox regression, with the first record of hospitalization due to a fall following the onset of PD as the outcome. Psychosis and anti-psychotic treatment were treated as time-dependent covariates in each model. Each model includes adjustments for patient age, sex, and presenting symptoms of PD– tremors and bradykinesia.

Results: Of the 297 incident cases of PD between 1991-2010, 114 (38.4%) met the criteria for PDP at any timepoint. The median age of psychosis onset was 79 years (Q1-Q3 73-85; IQR: 12) and the median time between onset of PD and onset of PDP was 8.1 years (Q1= 5.67 Q3= 10.61 and IQR=4.94). Patients with PDP had a 14% (HR = 1.14, p=0.005) increased risk for hospital admission compared to PD patients without psychosis. Among PDP patients, anti-psychotics use (55/110) was not associated with the risk of hospital admissions (HR = 1.10, p = .88). PDP patients had a 41% (HR 1.41, p=0.019) increased risk of hospitalization due to falling compared to PD patients. Among PDP patients, treatment with anti-psychotics was not associated with risk of hospitalization due to falls (HR=1.17, p=0.39).

Conclusion: PDP patients have a 14% greater risk of hospital admission compared to PD patients. Among PDP patients, treatment with anti-psychotic medications was not associated with risk of hospitalization.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-of-hospital-admission-in-patients-with-parkinsons-disease-associated-psychosis-1991-2010/