Cerebrospinal fluid in long-lasting delirium compared with Alzheimer's dementia.

BACKGROUND: Delirium is a common syndrome affecting older people in hospital, whose pathophysiology is poorly understood, but sequelae of increased cognitive and functional impairment suggest neuronal loss.

METHODS: Cohort study comparing cerebrospinal fluid, blood, and clinical markers of delirium and neuronal cell death in 20 older hospitalized patients with delirium and 20 outpatients with Alzheimer's dementia.

RESULTS: Compared with participants with dementia, patients with delirium demonstrated higher CSF lactate (1.87 vs 1.48 mmol/L, p < .001) and protein levels (0.62 vs 0.44 g/L, p = .036) and lower levels of neuron-specific enolase (4.84 vs 8.98 ng/mL, p < .001) but no difference in S100B. The changes correlated with clinical indices and outcomes.

CONCLUSION: Older patients with delirium experience significant metabolic disturbance in the brain, which requires further investigation.