Cytokines and acute phase response in delirium

J Psychosom Res. 2007 May;62(5):521-5. doi: 10.1016/j.jpsychores.2006.11.013.


Objective: This study aimed to examine the expression patterns of pro- and anti-inflammatory cytokines in elderly patients with and without delirium who were acutely admitted to the hospital.

Methods: All consecutive patients aged 65 years and older, who were acutely admitted to the Department of Internal Medicine of the Academic Medical Center, Amsterdam, a tertiary university teaching hospital, were invited. Members of the geriatric consultation team completed a multidisciplinary evaluation for all study participants within 48 h after admission, including cognitive and functional examination by validated measures of delirium, memory, and executive function. C-reactive protein and cytokines (IL-1beta, IL-6, TNF-alpha, IL-8, and IL-10) were determined within 3 days after admission.

Results: In total, 185 patients were included; mean age was 79 years; 42% were male; and 34.6% developed delirium within 48 h after admission. Compared to patients without delirium, patients with delirium were older and had experienced preexistent cognitive impairment more often. In patients with delirium, significantly more IL-6 levels (53% vs. 31%) and IL-8 levels (45% vs. 22%) were above the detection limit as compared with patients who did not have delirium. After adjusting for infection, age, and cognitive impairment, these differences were still significant.

Conclusions: Proinflammatory cytokines may contribute to the pathogenesis of delirium in acutely admitted elderly patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Acute-Phase Reaction / immunology*
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / immunology
  • Cytokines / blood*
  • Delirium / immunology*
  • Disability Evaluation
  • Female
  • Geriatric Assessment
  • Humans
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Male
  • Mental Status Schedule
  • Patient Admission*
  • Patient Care Team
  • Reference Values


  • Cytokines
  • Interleukin-6
  • Interleukin-8