Neopterin: a potential biomarker for delirium in elderly patients

Dement Geriatr Cogn Disord. 2015;39(1-2):116-24. doi: 10.1159/000366410. Epub 2014 Nov 19.

Abstract

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Delirium / blood*
  • Female
  • Humans
  • Insulin-Like Growth Factor Binding Protein 1 / blood
  • Interleukin-6 / blood
  • Male
  • Neopterin / blood*
  • Oxidative Stress / physiology

Substances

  • Biomarkers
  • Insulin-Like Growth Factor Binding Protein 1
  • Interleukin-6
  • Neopterin