OBJECTIVE: Pathophysiological mechanisms leading to delirium are not clear. Age is a known risk factor and hypothesised to be accompanied by a low-grade inflammatory state. Previous studies have shown an association between delirium and circulating proinflammatory markers in acutely ill and postoperative patients. In light of the ageing/inflammation theory, we investigated the association of these markers with delirium in not acutely ill, elderly patients. METHODS: In a prospective nested case-control study levels of C-reactive protein (CRP), interleukin 6 (Il-6), insulin growth factor 1 (IGF-1) were measured pre-operatively in elderly patients admitted for hip-surgery. These levels were compared between patients who later developed a post-operative delirium and patients who did not. Patients were matched for age and disease severity. RESULTS: Eighteen patients who developed delirium post-operatively were matched with 50 controls. Median APACHE-scores were below 16 in both groups. Pre-operative serum concentrations of CRP, Il-6 and IGF-1 did not differ between groups. IL-6 levels were associated with a measure of cognitive impairment. CONCLUSION: In the present study no relationship was found between levels of pre-operative circulating pro-inflammatory markers and post-operative delirium in elderly patients, who were free from acute or severe disease.
OBJECTIVE: Pathophysiological mechanisms leading to delirium are not clear. Age is a known risk factor and hypothesised to be accompanied by a low-grade inflammatory state. Previous studies have shown an association between delirium and circulating proinflammatory markers in acutely ill and postoperative patients. In light of the ageing/inflammation theory, we investigated the association of these markers with delirium in not acutely ill, elderly patients. METHODS: In a prospective nested case-control study levels of C-reactive protein (CRP), interleukin 6 (Il-6), insulin growth factor 1 (IGF-1) were measured pre-operatively in elderly patients admitted for hip-surgery. These levels were compared between patients who later developed a post-operative delirium and patients who did not. Patients were matched for age and disease severity. RESULTS: Eighteen patients who developed delirium post-operatively were matched with 50 controls. Median APACHE-scores were below 16 in both groups. Pre-operative serum concentrations of CRP, Il-6 and IGF-1 did not differ between groups. IL-6 levels were associated with a measure of cognitive impairment. CONCLUSION: In the present study no relationship was found between levels of pre-operative circulating pro-inflammatory markers and post-operative delirium in elderly patients, who were free from acute or severe disease.
Authors: Simon T Dillon; Sarinnapha M Vasunilashorn; Long Ngo; Hasan H Otu; Sharon K Inouye; Richard N Jones; David C Alsop; George A Kuchel; Eran D Metzger; Steven E Arnold; Edward R Marcantonio; Towia A Libermann Journal: Biol Psychiatry Date: 2016-03-25 Impact factor: 13.382
Authors: A Morandi; M L Gunther; P P Pandharipande; J C Jackson; J L Thompson; A K Shintani; E W Ely; T D Girard Journal: Int Psychogeriatr Date: 2011-02-04 Impact factor: 3.878
Authors: Karin J Neufeld; O Joseph Bienvenu; Paul B Rosenberg; Simon C Mears; Hochang B Lee; Biren B Kamdar; Frederick E Sieber; Sharon K Krumm; Jeremy D Walston; David N Hager; Pegah Touradji; Dale M Needham Journal: J Am Geriatr Soc Date: 2011-11 Impact factor: 5.562
Authors: Chantal J Slor; Joost Witlox; Dimitrios Adamis; David J Meagher; Tjeerd van der Ploeg; Rene W M M Jansen; Mireille F M van Stijn; Alexander P J Houdijk; Willem A van Gool; Piet Eikelenboom; Jos F M de Jonghe Journal: Curr Gerontol Geriatr Res Date: 2013-02-27