Magnetic resonance spectroscopy in hospitalised older people shows age and delirium-specific metabolic changes.

Background Delirium is common in hospitalised older people and is associated with a poor prognosis. It remains poorly characterised at a molecular level. We studied the metabolic signature of delirium using H-Magnetic Resonance Spectroscopy (MRS) in a prospective case-control study. Methods Medical...

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Publicado en:Age & Ageing Vol. 55; no. 2; pp. 1 - 11
Autores principales: Richardson, Daniel, Mahmood, Aisha, Binnie, Lauren, Khan, Uzma, Rich, Philip, Davis, Daniel H J, Hainsworth, Atticus H, Howe, Franklyn A, Isaacs, Jeremy D
Formato: Artículo
Publicado: Oxford University Press / USA Feb2026
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Magnetic resonance spectroscopy in hospitalised older people shows age and delirium-specific metabolic changes.
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        au:
          Richardson, Daniel
          Mahmood, Aisha
          Binnie, Lauren
          Khan, Uzma
          Rich, Philip
          Davis, Daniel H J
          Hainsworth, Atticus H
          Howe, Franklyn A
          Isaacs, Jeremy D
        affil:
          Emergency Medicine, King's College Hospital NHS Foundation Trust, London, England, UKNeuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK
          Neuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK
          Department of Neurology, Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, England, UK
          St George's Vaccine Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK
          MRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, England, UK
          Neuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UKDepartment of Neurology, Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, England, UK
      su:
        Hospital care
        Case-control method
        Old age
        Metabolic disorders
        Nuclear magnetic resonance spectroscopy
        Delirium in old age
        Research funding
        Frail elderly
        Descriptive statistics
        Severity of illness index
        Mann Whitney U Test
        Longitudinal method
        Cognition disorders
        Data analysis software
        Regression analysis
      sug:
        subj:
          Hospital care
          Case-control method
          Old age
          Metabolic disorders
          Nuclear magnetic resonance spectroscopy
          Delirium in old age
          Research funding
          Frail elderly
          Descriptive statistics
          Severity of illness index
          Mann Whitney U Test
          Longitudinal method
          Cognition disorders
          Data analysis software
          Regression analysis
      keyword:
        antibody-drug conjugates
        brain
        cognition disorders
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        dementia
        frail
        glutamate
        https://dx.doi.org/10.1093/ageing/afag013
        humans
        inLanguage:en
        magnetic resonance spectroscopy
        metabolites
        older adult
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41627307/
        antibody-drug conjugates
        brain
        cognition disorders
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        dementia
        frail
        glutamate
        https://dx.doi.org/10.1093/ageing/afag013
        humans
        inLanguage:en
        magnetic resonance spectroscopy
        metabolites
        older adult
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41627307/
      ab: Background Delirium is common in hospitalised older people and is associated with a poor prognosis. It remains poorly characterised at a molecular level. We studied the metabolic signature of delirium using H-Magnetic Resonance Spectroscopy (MRS) in a prospective case-control study. Methods Medical inpatients aged ≥65 with and without delirium (DSM-5) were recruited and assessed for illness severity, frailty and prior cognitive decline. Metabolite concentrations in parietal white matter were obtained using MRS with diffusion MRI used to assess structural changes via the ADC. Results Out of 38 participants, 25 completed the MRS protocol (13 males and 12 females, mean age 80.5, SD = 6.47). Patients with delirium (n  = 13) had greater pre-admission frailty than those without (n  = 12) (median Clinical Frailty Scale 5 vs. 4.5; P  = .049). There were no significant differences in age, sex, measures of MRS quality, atrophy and white matter disease. In a General Linear Model using the MRS voxel ADC to account for white matter lesion effects, glutamate was higher in delirium patients (P  = 0.024). There were no other between-group differences in metabolite concentrations. For patients with and without delirium combined, glutamine increased with age and decreased with cortical atrophy, whilst Myo-inositol decreased with age and increased with median ADC. Conclusions Our results suggest that delirium is characterised by elevated brain glutamate concentration. This could cause excitotoxic brain injury and contribute to post-delirium cognitive decline and is a potentially modifiable process that merits further investigation.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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