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  11. Protocol For A Prospective Cohort Study To Determine The Multimodal Biomarkers Of Delirium And New Dementia After Acute Illness In Older Adults: Orchard-ps

Protocol for a prospective cohort study to determine the multimodal biomarkers of delirium and new dementia after acute illness in older adults: ORCHARD-PS

Jasmine Ming Gan1, Lily Elderton1, Meenu Vijayakumar Sheela2

  • 1Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

BMJ Open
|June 13, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Delirium in older adults is linked to dementia. The ORCHARD-PS study investigates delirium pathophysiology and cognitive decline using multimodal biomarkers to understand this relationship.

Area of Science:

  • Gerontology
  • Neuroscience
  • Clinical Medicine

Background:

  • Delirium is a common, serious condition in older hospital patients, often linked to acute illness.
  • It is associated with poor outcomes, including cognitive decline and dementia, suggesting it may be a modifiable dementia risk factor.
  • The exact mechanisms linking delirium to dementia and the impact of acute illness factors remain unclear, with limited biomarker research in acute settings.

Purpose of the Study:

  • To elucidate the pathophysiology of delirium and subsequent cognitive decline in older adults after acute illness.
  • To acquire multimodal biomarkers for deep phenotyping of delirium and acute illness.
  • To follow participants for incident dementia to understand the delirium-dementia relationship.

Main Methods:

  • A bi-centre, prospective cohort study (ORCHARD-PS) of patients aged 65+ without advanced dementia or terminal illness.
Keywords:
Clinical ProtocolsCognitionDeliriumDementia

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  • Comprehensive data collection including demographics, comorbidities, delirium assessment (4A's test, CAM, etc.), and cognitive tests (AMT, MoCA).
  • Multimodal biomarker acquisition (blood, CT/MRI brain imaging) and follow-up at 3 months, 1 year, and 3 years for cognitive status and incident dementia.

    • Main Results:

    • The study is designed to collect detailed data on delirium, acute illness, and cognitive trajectories.
    • Biomarker associations with delirium and incident dementia will be analyzed using logistic or Cox regression.
    • The study will provide insights into the mechanisms underlying the delirium-dementia link.

    Conclusions:

    • The ORCHARD-PS study aims to provide a deep phenotyping of delirium and acute illness in older adults.
    • It will investigate the role of multimodal biomarkers in the relationship between delirium and subsequent cognitive decline, including dementia.
    • Findings are expected to inform potential interventions for dementia prevention in older adults.
    GERIATRIC MEDICINE
    INTERNAL MEDICINE