Prevalence and risk factors for visual hallucinations in Chinese patients with Parkinson's disease

Parkinson's disease (PD) patients frequently present visual hallucinations (VHs)·The determinants of VHs in Chinese PD patients remain largely unknown. The aim of this study was to illuminate the prevalence and clinical correlates of VHs in the Chinese population with PD.

A total of 371 consecutive, idiopathic PD patients were recruited into the study. Patients were categorized as hallucinators and nonhallucinators according to Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

VHs were observed in 72 (19.4%) patients. Among them, 26.4% of the hallucinators experienced minor hallucinations, and 73.6% had complex visual hallucinations. The age, disease duration, percentage of patients using dopamine agonists, UPDRS part III, Hoehn and Yahr (H-Y) stage, and Non-Motor Symptoms Questionnaire (NMS-Quest) score in hallucinators were significantly greater than in nonhallucinators (P<0.05). The Montreal Cognitive Assessment (MOCA) and PD Sleep Scale (PDSS) scores in nonhallucinators were significantly higher than in hallucinators (P<0.05). The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores were not different between the hallucinators and nonhallucinators. The forward binary logistic regression model showed that disease duration, dopamine agonist use, sleep quality, and cognition were associated with VHs in PD patients.

Our results confirm the high prevalence of VHs in patients with PD. The VHs are associated with duration, dopamine agonist use, sleep quality, and cognition, and should trigger further inquiry by neurologists.