Serum biomarkers for delirium.
This narrative review examines serum biomarkers for the diagnosis and monitoring of delirium. Serum biomarkers for delirium fall into three major groups: 1) those that are present or elevated prior to disease onset-risk markers, 2) those that rise with onset and fall with recovery-disease markers, and 3) those that rise in proportion to the consequences of disease-end products. As risk markers, we examine serum chemistries and genetic risk markers. As disease markers, we examine serum anticholinergic activity, amino acids, melatonin, cytokines, cortisol, and gene expression. As end products of delirium, we examine markers of neuronal injury. Finally, we discuss methodological and biostatistical considerations for future biomarker studies. Identifying accurate biomarkers for delirium may shed further light into its pathophysiology and on the interrelationship between delirium and dementia.
Marcantonio
Edward R
ER
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02446, USA. emarcant@bidmc.harvard.edu
Rudolph
James L
JL
Culley
Deborah
D
Crosby
Gregory
G
Alsop
David
D
Inouye
Sharon K
SK
D000109:Acetylcholine / Q000097:blood; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D018680:Cholinergic Antagonists / Q000097:blood; D003693:Delirium / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D005819:Genetic Markers; D006801:Humans; D008550:Melatonin / Q000097:blood; D012701:Serotonin / Q000097:blood
D000596:Amino Acids; D015415:Biomarkers; D018680:Cholinergic Antagonists; D005819:Genetic Markers; D012701:Serotonin; D008550:Melatonin; D000109:Acetylcholine