Neopterin: A Potential Biomarker for Delirium in Elderly Patients

• Published in: Dementia and geriatric cognitive disorders Vol. 39; no. 1-2; pp. 116 - 124
• Main Authors: Egberts, Angelique, Wijnbeld, Eline H.A., Fekkes, Durk, van der Ploeg, Milly A., Ziere, Gijsbertus, Hooijkaas, Herbert, van der Cammen, Tischa J.M., Mattace-Raso, Francesco U.S.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2015
• Subjects: Aged; Aged patients; Aged, 80 and over; Analysis; Biological markers; Biomarkers - blood; Delirium; Delirium - blood; Demographic aspects; Diagnosis; Female; Health aspects; Humans; Insulin-like growth factor 1; Insulin-Like Growth Factor Binding Protein 1 - blood; Interleukin-6; Interleukin-6 - blood; Male; Medical examination; Neopterin - blood; Original Research Article; Oxidative Stress - physiology; Risk factors; Netherlands; Delirium; Biomarkers; Insulin-like growth factor-1; Neopterin; Interleukin-6
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000366410

Background/Aims: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium. Methods: Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics. Differences in biomarker levels between patients with and without a delirium were investigated by the analysis of variance in models adjusted for age, gender, comorbidities and eGFR (when appropriate). Results: Eighty-six patients were included; 23 of them with a delirium. In adjusted models, higher mean levels of neopterin (70.5 vs. 45.9 nmol/l, p = 0.009) and IL-6 (43.1 vs. 18.5 pg/ml, p = 0.034) and lower mean levels of IGF-1 (6.3 vs. 9.3 nmol/l, p = 0.007) were found in patients with a delirium compared to those without. Conclusions: The findings of this study suggest that neopterin might be a potential biomarker for delirium which, through oxidative stress and activation of the immune system, may play a role in the pathophysiology of delirium. © 2014 S. Karger AG, Basel