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...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 11 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513142&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513142 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513142 10.1093/ageing/afag013 ppf: 1 ppct: 10 formats: tig: atl: Magnetic resonance spectroscopy in hospitalised older people shows age and delirium-specific metabolic changes. aug: 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 refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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