Longitudinal assessment of serum anticholinergic activity in delirium of the elderly

Abstract Background Delirium, a frequently occurring, devastating disease, is often underdiagnosed, especially in dementia. Serum anticholinergic activity (SAA) was proposed as a disease marker as it may reflect delirium's important pathogenetic mechanism, cholinergic deficiency. We assessed th...

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Bibliographic Details
Published in:Journal of psychiatric research 2012-10, Vol.46 (10), p.1339-1345
Main Authors: van Munster, Barbara C, Thomas, Christine, Kreisel, Stefan H, Brouwer, Jantien P, Nanninga, Stephanie, Kopitz, Juergen, de Rooij, Sophia E
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Anticholinergics
Biological and medical sciences
Biomarker
Cholinergic Antagonists - metabolism
Cognitive impairment
Delirium
Delirium - blood
Dementia
Female
Fractured hips
Geriatrics
Hip fracture
Humans
Hydrocortisone - blood
Indexing in process
Interleukin-6 - blood
Longitudinal Studies
Male
Medical sciences
Muscarinic Antagonists
Old age
Organic mental disorders. Neuropsychology
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Quinuclidinyl Benzilate
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Serum
Sick elderly people
Surgery
Tritium
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Summary:Abstract Background Delirium, a frequently occurring, devastating disease, is often underdiagnosed, especially in dementia. Serum anticholinergic activity (SAA) was proposed as a disease marker as it may reflect delirium's important pathogenetic mechanism, cholinergic deficiency. We assessed the association of serum anticholinergic activity with delirium and its risk factors in a longitudinal study on elderly hip fracture patients. Method Consecutive elderly patients admitted for hip fracture surgery ( n  = 142) were assessed longitudinally for delirium, risk factors, and serum markers (IL-6, cortisol, and SAA). Using a sophisticated statistical design, we evaluated the association between SAA and delirium in general and with adjustments, but also the temporal course, including the events fracture, surgery, and potential delirium, individual confounders, and a propensity score. Results Among elderly hip fracture patients 51% developed delirium, these showed more risk factors ( p  
ISSN:0022-3956
1879-1379
DOI:10.1016/j.jpsychires.2012.06.015