Evidence map›Paper›PMID 41627307›Full record

ArticleAge and ageing2026

Magnetic resonance spectroscopy in hospitalised older people shows age and delirium-specific metabolic changes.

Daniel Richardson, Aisha Mahmood, Lauren Binnie, Uzma Khan, Philip Rich, Daniel H J Davis, Atticus H Hainsworth, Franklyn A Howe, Jeremy D Isaacs

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Article in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Daniel RichardsonEmergency Medicine, King's College Hospital NHS Foundation Trust, London, England, UK.ORCID 0000-0001-8799-7509
Aisha MahmoodNeuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK.
Lauren BinnieDepartment of Neurology, Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, England, UK.
Uzma KhanSt George's Vaccine Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK.
Philip RichDepartment of Neurology, Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, England, UK.
Daniel H J DavisMRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, England, UK.ORCID 0000-0002-1560-1955
Atticus H HainsworthNeuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK.
Franklyn A HoweNeuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK.
Jeremy D IsaacsNeuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, England, UK.ORCID 0000-0002-2745-9597

Funding

Alzheimer's Research UK (Kings College London network) and the Wellcome Trust 204809/Z/16/Z
6 · The paper itself

Abstract

backgroundDelirium is common in hospitalised older people and is associated with a poor prognosis. It remains poorly characterised at a molecular level. We studied the metabolic signature of delirium using 1H-Magnetic Resonance Spectroscopy (MRS) in a prospective case-control study.

methodsMedical inpatients aged ≥65 with and without delirium (DSM-5) were recruited and assessed for illness severity, frailty and prior cognitive decline. Metabolite concentrations in parietal white matter were obtained using MRS with diffusion MRI used to assess structural changes via the ADC.

resultsOut of 38 participants, 25 completed the MRS protocol (13 males and 12 females, mean age 80.5, SD = 6.47). Patients with delirium (n = 13) had greater pre-admission frailty than those without (n = 12) (median Clinical Frailty Scale 5 vs. 4.5; P = .049). There were no significant differences in age, sex, measures of MRS quality, atrophy and white matter disease. In a General Linear Model using the MRS voxel ADC to account for white matter lesion effects, glutamate was higher in delirium patients (P = 0.024). There were no other between-group differences in metabolite concentrations. For patients with and without delirium combined, glutamine increased with age and decreased with cortical atrophy, whilst Myo-inositol decreased with age and increased with median ADC.

conclusionsOur results suggest that delirium is characterised by elevated brain glutamate concentration. This could cause excitotoxic brain injury and contribute to post-delirium cognitive decline and is a potentially modifiable process that merits further investigation.

Indexed as

AgingDeliriumHospitalizationProton Magnetic Resonance SpectroscopyWhite MatterAgedAged, 80 and overAge FactorsAtrophyBiomarkersCase-Control StudiesDiffusion Magnetic Resonance ImagingFemaleFrailtyGlutamic AcidGlutamineBiomarkersGlutamic AcidGlutamineInositolcognition disordersdeliriumdementiafrailhumansmagnetic resonance spectroscopyolder people

Identifiers

PMID41627307
PMCPMC12862978

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