BACKGROUND: Delirium is a common syndrome affecting older people in hospital, whose pathophysiology is poorly understood, but sequelae of increased cognitive and functional impairment suggest neuronal loss. METHODS: Cohort study comparing cerebrospinal fluid, blood, and clinical markers of delirium and neuronal cell death in 20 older hospitalized patients with delirium and 20 outpatients with Alzheimer's dementia. RESULTS: Compared with participants with dementia, patients with delirium demonstrated higher CSF lactate (1.87 vs 1.48 mmol/L, p < .001) and protein levels (0.62 vs 0.44 g/L, p = .036) and lower levels of neuron-specific enolase (4.84 vs 8.98 ng/mL, p < .001) but no difference in S100B. The changes correlated with clinical indices and outcomes. CONCLUSION: Older patients with delirium experience significant metabolic disturbance in the brain, which requires further investigation.
BACKGROUND:Delirium is a common syndrome affecting older people in hospital, whose pathophysiology is poorly understood, but sequelae of increased cognitive and functional impairment suggest neuronal loss. METHODS: Cohort study comparing cerebrospinal fluid, blood, and clinical markers of delirium and neuronal cell death in 20 older hospitalized patients with delirium and 20 outpatients with Alzheimer's dementia. RESULTS: Compared with participants with dementia, patients with delirium demonstrated higher CSFlactate (1.87 vs 1.48 mmol/L, p < .001) and protein levels (0.62 vs 0.44 g/L, p = .036) and lower levels of neuron-specific enolase (4.84 vs 8.98 ng/mL, p < .001) but no difference in S100B. The changes correlated with clinical indices and outcomes. CONCLUSION: Older patients with delirium experience significant metabolic disturbance in the brain, which requires further investigation.
Authors: Tamara G Fong; Sarinnapha M Vasunilashorn; Towia Libermann; Edward R Marcantonio; Sharon K Inouye Journal: Int J Geriatr Psychiatry Date: 2019-03-15 Impact factor: 3.485
Authors: Tamara G Fong; Sarinnapha M Vasunilashorn; Edward R Marcantonio; Sharon K Inouye; Long Ngo; Towia A Libermann; Simon T Dillon; Eva M Schmitt; Alvaro Pascual-Leone; Steven E Arnold; Richard N Jones Journal: Ann Neurol Date: 2020-09-15 Impact factor: 10.422
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