Cerebrospinal fluid in long-lasting delirium compared with Alzheimer's dementia.
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.


CONCLUSIONS
Older patients with delirium experience significant metabolic disturbance in the brain, which requires further investigation.
1 Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia. g.caplan@unsw.edu.au
Gideon A
GA
Caplan
Tasha
T
Kvelde
Christina
C
Lai
Swee L
SL
Yap
Cheryl
C
Lin
Mark A
MA
Hill
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D003693:Delirium / Q000134:cerebrospinal fluid*; D006801:Humans; D007773:Lactates / Q000097:blood / Q000134:cerebrospinal fluid; D009414:Nerve Growth Factors / Q000134:cerebrospinal fluid; D009483:Neuropsychological Tests; D010751:Phosphopyruvate Hydratase / Q000138:chemical synthesis; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000134:cerebrospinal fluid
D002556:Cerebrospinal Fluid Proteins; D007773:Lactates; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D010751:Phosphopyruvate Hydratase