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. 2024 Jan;39(1):e6044.
doi: 10.1002/gps.6044.

Biomarkers of neurodegeneration and neural injury as potential predictors for delirium

Tamara G Fong  1   2   3 , Sarinnapha M Vasunilashorn  3   4   5 , Pia Kivisäkk  3   6 , Eran D Metzger  2   3 , Eva M Schmitt  2 , Edward R Marcantonio  3   4   7 , Richard N Jones  8 , Hannah T Shanes  2 , Steven E Arnold  3   6 , Sharon K Inouye  2   3   7 , Long H Ngo  3   4   9
Affiliations

Biomarkers of neurodegeneration and neural injury as potential predictors for delirium

Tamara G Fong et al. Int J Geriatr Psychiatry. 2024 Jan.

Abstract

Objectives: Determine if biomarkers of Alzheimer's disease and neural injury may play a role in the prediction of delirium risk.

Methods: In a cohort of older adults who underwent elective surgery, delirium case-no delirium control pairs (N = 70, or 35 matched pairs) were matched by age, sex and vascular comorbidities. Biomarkers from CSF and plasma samples collected prior to surgery, including amyloid beta (Aβ)42 , Aβ40 , total (t)-Tau, phosphorylated (p)-Tau181 , neurofilament-light (NfL), and glial fibrillary acid protein (GFAP) were measured in cerebrospinal fluid (CSF) and plasma using sandwich enzyme-linked immunosorbent assays (ELISAs) or ultrasensitive single molecule array (Simoa) immunoassays.

Results: Plasma GFAP correlated significantly with CSF GFAP and both plasma and CSF GFAP values were nearly two-fold higher in delirium cases. The median paired difference between delirium case and control without delirium for plasma GFAP was not significant (p = 0.074) but higher levels were associated with a greater risk for delirium (odds ratio 1.52, 95% confidence interval 0.85, 2.72 per standard deviation increase in plasma GFAP concentration) in this small study. No matched pair differences or associations with delirium were observed for NfL, p-Tau 181, Aβ40 and Aβ42 .

Conclusions: These preliminary findings suggest that plasma GFAP, a marker of astroglial activation, may be worth further investigation as a predictive risk marker for delirium.

Keywords: AD biomarkers; delirium; neural injury biomarkers.

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Conflict of interest statement

The authors have declared that no conflict of interest exists.

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