Hospital admissions rising for elderly patients with Parkinson's disease

November 15, 2016

Although treatment for Parkinson's disease (PD) is significantly extending the lives of patients, these patients are now being admitted to hospitals at increasing rates. In a study reported in the Journal of Parkinson's Disease, researchers in Ireland have found that the top five reasons for hospital admission of PD patients are urinary tract infections, pneumonia, lower respiratory tract infections, aspiration pneumonia and femur fracture. More troubling is the stark increase in PD patients requiring long-term nursing home care on discharge, with 27% of the over 65 group discharged to a nursing home compared to 12% admitted from a nursing home.

Using data from the Hospital Inpatient Enquiry (HIPE) system in Ireland between 2009 and 2012, 12,437 discharges of PD patients over 65, as well as 1,223 discharges of PD patients under 65, were examined. The top 10 principal diagnoses at admission, the top 10 principal procedures conducted, admission sources and routes, and final discharge destinations were tabulated.

The clear majority of hospital admissions were via the emergency department (87%). The most common reasons for admission for PD patients of all ages were acute lower respiratory infection, urinary system disorders, pneumonia (organism unspecified), pneumonitis due to solids and liquids (). Femur fractures was among the top five reasons for hospital admission in those over 65. Investigators also found a steady rise in acute hospital admission rates for the over-65 age group.

For PD patients, the in-hospital mortality rate was 8%, significantly higher than that previously documented for non-PD hospital admissions of the same age. Over the time of the study, the number of PD patients requiring long-term more than doubled in all age categories.

The researchers note that many of the reasons for can be targeted for intervention initiatives to prevent or treat these conditions before a hospital admission is required, thus reducing stress on emergency departments, lengthy in-patient stays, and potentially keeping patients in their own homes longer.

Because the number of people with PD in Ireland alone is predicted to double by 2030, the stresses on the acute hospital sector, including already-stressed emergency departments, will present major challenges. According to lead investigator Olive Lennon, PhD, from the School of Public Health, Physiotherapy and Sports Science at University College Dublin, Dublin, Ireland, "It is clear from this research that focus and investment is required at primary and community care levels to maintain people with PD in good health and continuing to live in their own homes and communities."

Co-investigator Catherine Blake, PhD, of the same institution, adds, "On a positive note, a lot of the causes of admission to hospital in PD in Ireland are preventable. Currently care delivered is disjointed and it is this fragmented approach that allows individuals to become seriously ill and require hospital admission. Integrated care pathways for community-dwelling adults with chronic neurological diseases, not just PD, should form the bedrock for health and wellness in this population going forward."

Explore further: Hospital-at-home is a safe alternative to hospital admission for elderly patients

More information: Bróna Kelly et al. Acute Hospital Admissions of Individuals with a Known Parkinson's Disease Diagnosis in Ireland 2009–2012: A Short Report, Journal of Parkinson's Disease (2016). DOI: 10.3233/JPD-160839

Related Stories

Hospital-at-home is a safe alternative to hospital admission for elderly patients

June 30, 2016
When considering admitting patients over the age of 65 for acute hospital care, alternatives such as hospital at home, admission to a local community hospital or extended stays and treatment in A&E are a viable option say ...

Increased risk of death for heart failure patients with each NHS hospital admission

August 28, 2016
Heart failure patients have a 2% increased risk of dying with each admission to NHS hospitals, according to research presented at ESC Congress 2016 today. The 15 year study in more than 450 000 patients from the ACALM Study ...

Risk of hospital admissions could be reduced with better general practice strategies

October 25, 2016
Hospital admission rates are 55 per cent higher in some areas than in others because of a greater prevalence of conditions such as diabetes, alcoholism, dementia and socioeconomic deprivation. According to research published ...

Changes to NHS policy unlikely to reduce emergency hospital admissions

January 29, 2016
Recent changes to UK healthcare policy intended to reduce the number of emergency hospital admissions are unlikely to be effective, according to a study published in the British Medical Journal.

Efforts to lower hospital admission rates may also reduce readmissions

July 6, 2016
Public health programs and initiatives that aim to lower hospital admission rates may also reduce readmissions, despite the fact that the patients in communities that have adopted these programs tend to be sicker when hospitalized, ...

Five-year mortality, costs up for ICU survivors

February 5, 2016
(HealthDay)—Intensive care unit (ICU) patients surviving to hospital discharge have higher five-year mortality and hospital resource use than hospital controls, according to a study published online Jan. 27 in the American ...

Recommended for you

Researchers find new path to promising Parkinson's treatment

September 19, 2017
Three researchers at The University of Alabama are part of work that is leading to a new direction for drug discovery in the quest to treat Parkinson's disease.

Tug of war between Parkinson's protein and growth factor

September 18, 2017
Alpha-synuclein, a sticky and sometimes toxic protein involved in Parkinson's disease (PD), blocks signals from an important brain growth factor, Emory researchers have discovered.

Medical history can point to earlier Parkinson's disease diagnosis

September 15, 2017
Before symptoms become pronounced, there is no reliable way to identify who is on track to develop Parkinson's disease, a debilitating movement disorder characterized by tremors, slowness of movement, stiffness, and difficulty ...

Brain rewiring in Parkinson's disease may contribute to abnormal movement

September 14, 2017
The brain's own mechanisms for dealing with the loss of dopamine neurons in Parkinson's disease may be a source of the disorder's abnormal movement, according to a Northwestern Medicine study published in Neuron.

Treating with antioxidants early in Parkinson's disease process may halt degeneration and improve neuronal function

September 7, 2017
Northwestern Medicine scientists have identified a toxic cascade that leads to neuronal degeneration in patients with Parkinson's disease (PD) and figured out how to interrupt it, reports a study to be published September ...

New diagnostic tool spots first signs of Parkinson's disease

September 6, 2017
Researchers have developed the first tool that can diagnose Parkinson's disease when there are no physical symptoms, offering hope for more effective treatment of the condition.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.