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Cortisol, interleukins and S100B in delirium in the elderly
Barbara C van Munster1, Peter H Bisschop, Aeilko H Zwinderman
1Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, The Netherlands. b.c.vanmunster@amc.uva.nl
Brain and Cognition
|June 29, 2010
Summary
Delirium in older hip fracture patients is linked to biomarkers. S100B protein levels were the strongest independent predictor of delirium, even after accounting for cognitive impairment.
Area of Science:
- Biochemistry
- Geriatric Medicine
- Neuroscience
Background:
- Delirium is a common complication in elderly patients undergoing hip fracture surgery.
- Previous studies suggest associations between delirium and elevated levels of cortisol, interleukins (ILs), and S100B protein.
Purpose of the Study:
- To simultaneously compare serum levels of cortisol, IL-6, IL-8, and S100B in elderly hip fracture patients with and without delirium.
- To identify potential biomarkers for delirium in this patient population.
Main Methods:
- Blood samples were collected repeatedly from 120 patients (mean age 84 years) admitted for hip fracture surgery.
- Serum concentrations of cortisol, IL-6, IL-8, and S100B were measured.
- Multivariable analysis was used to assess the association of these biomarkers with delirium, adjusting for pre-existing cognitive impairment.
Main Results:
- Highest levels of IL-8 and cortisol were observed before the onset of delirium.
- Interleukin-6 (IL-6) and S100B protein levels peaked during delirium.
- Multivariable analysis indicated that cortisol, IL-6, and S100B were significantly associated with delirium.
- After adjusting for pre-existing cognitive impairment, only S100B remained a significant independent predictor of delirium.
Conclusions:
- Cortisol, IL-6, and S100B may play a role in the pathogenesis of delirium in elderly hip fracture patients.
- S100B protein is identified as the strongest independent biomarker associated with delirium in this cohort.
- Further research is warranted to elucidate the precise mechanisms involving these biomarkers in delirium development.
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