Sep 11, 2017

New Research May Have Found the Cause of Delirium

Delirium is a medical condition where a person goes through a period of confusion and other disruptions in thinking and behavior – this includes changes in perception, attention, mood and activity level.

It can be challenging for the people who experience delirium, as well as those around them.

Delirium is particularly common for older patients who have recently had surgery. For them, symptoms can include memory loss, reduced awareness of the environment, poor thinking skills, behaviour changes and emotional disturbances.

One of the most challenging aspects of delirium is that symptoms are so similar dementia, that one can often be misdiagnosed for the other.

The most distinct difference is that delirium is a temporary condition, at the very most it will last a few weeks.

But what causes delirium? A new research from the Prince of Wales Hospital looked into how and why delirium occurs.

Associate Professor Gideon Caplan told Dementia Daily that “understanding what’s happening in the brain in delirium is vital because we have no licensed treatment for delirium to use in our Emergency Departments or on our wards.”

“To discover treatments, we need to know what we’re treating,”

The Director of Geriatric Medicine explained that one in four people over 65 experience delirium, and that it is even more common in people with dementia when they go into hospital.

By comparing brain scans of people who were displaying delirium, before and after the episode, researchers were able to analyse the changes that occurred in the brain when a person has delirium.

The team looked at scans of thirteen elderly participants during delirium, six of whom were scanned again after resolution.

Published in the the Journal of Cerebral Blood Flow & Metabolism, what was found in the brain scans was that there was abnormal glucose metabolism, also known as “cortical hypometabolism”.

Because the brain is not metabolising glucose properly, parts of the brain connected with attention, executive function and cognitive function, memory are impaired in delirium due.

This cortical hypometabolism was evident in all participants during delirium, and interestingly, it improved once the delirium had passed.

The study also found that the decrease in glucose metabolism seen in people with delirium, is equal to the average decrease in glucose metabolism seen in a year in a person with Alzheimer’s disease- suggesting that there may treating these medical issues could help with dementia symptoms.

Following this discovery, Associate Professor Caplan hopes to find a viable treatment for delirium, “we now have Ethics approval and need one more approval before we start our first intervention trial. We are also continuing to expand the PET [brain] scan study to understand whether there are differences between different types of delirium,” he said.

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