What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- Elevated TDP-43 serum levels associated with postoperative delirium following major cardiac surgery
- Authors
- Simon, C. Graves, O. K. Akeju, O. McKay, T. B.
- Year
- 2025
- Journal
- Brain Behav Immun Health
- Abstract
BACKGROUND: Postoperative delirium is a recurring complication among vulnerable patients undergoing major cardiac surgery. While delirium has been associated with prodromal dementia, there is minimal evidence to support the causality of this nuanced relationship. Clarification as to how postoperative delirium might lead to neurodegenerative dementias, perhaps through evidence of contemporaneous biomarkers, would heighten the plausibility of a causal correlation. TAR DNA-binding protein 43 (TDP-43), a nuclear protein essential for transcriptional events, has been linked to pathological aggregation in Alzheimer’s disease (AD) and AD-related dementias (ADRD). METHODS: Circulating TDP-43 levels in cardiac surgical patients aged 60 years and older were evaluated in a biobank derived from the Minimizing ICU Neurological Dysfunction with Dexmedetomidine-induced Sleep (MINDDS) clinical trial. Serum total TDP-43 levels, measured with a single molecule array (Simoa), were compared across preoperative and postoperative day one timepoints according to delirium status assessed using the Confusion Assessment Method (CAM). To investigate the temporal changes in serum TDP-43, an independent validation cohort of 25 patients aged 60 years and older undergoing major cardiac surgery was analyzed. RESULTS: Total serum TDP-43 levels increased by 16.5% (95% CI: 5.9%-27.9%, p = 0.0021) on postoperative day one compared to baseline levels. This increase was more pronounced in patients who experienced delirium (median increase of 55.1%, 95% CI: 22.9%-96.4%, p = 0.0002). Further, these findings were conserved in multiple logistic regression models adjusting for treatment, age, sex, and baseline cognitive scores. In the validation cohort, TDP-43 levels were found to be significantly elevated immediately following cardiopulmonary bypass from the baseline, with a gradual decrease by postoperative day one. CONCLUSIONS: Our findings demonstrate that post-cardiac surgery delirium among vulnerable patients is associated with significant elevations in circulating TDP-43. This relationship suggests that TDP-43 may serve as a prognostic biomarker for acute neurological insults and blood-brain barrier integrity following cardiac surgery. Overall, our results provide mechanistic insights into the inter-relationship between postoperative delirium and subsequent cognitive impairment, potentially offering new avenues for early intervention in at-risk surgical patients.
- PMID
PMID: 40134937
PMCID: PMC11932660
- Keywords
Postoperative delirium, vulnerable patients, major cardiac surgery, prodromal dementia, TDP-43
- Page(s)
- Volume
- Issue
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Factors Associated with Length of Stay in Hospital Patients with and Without Dementia. | Möllers, T. Perna, L. Ihle, P. Schubert, I. Bauer, J. Brenner, H. | Journal of Alzheimer's Disease | 2019 |
adult |
| Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients. | Zhou, W. Ngo, L. H. Inouye, S. K. Gallagher, J. Husser, E. K. Fick, D. M. Marcantonio, E. R. | Journal of General Internal Medicine | 2018 |
adult |
| Serum soluble fibrinogen-like protein 2 concentration predicts delirium after acute pancreatitis. | Xu, W. B. Hu, Q. H. Wu, C. N. Fan, Z. K. Song, Z. F. | Brain Behav | 2019 |
acute pancreatitis |
| Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study. | Wilson, J. E. Boehm, L. Samuels, L. R. Unger, D. Leonard, M. Roumie, C. Ely, E. W. Dittus, R. S. Misra, S. Han, J. H. | Palliat Support Care | 2019 |
cognition |
| Relative cerebral hyperperfusion during cardiopulmonary bypass is associated with risk for postoperative delirium: a cross-sectional cohort study. | Thudium, M. Ellerkmann, R. K. Heinze, I. Hilbert, T. | BMC Anesthesiology | 2019 |
Cardiac surgery |
| Prediction of postoperative delirium by comprehensive geriatric assessment among elderly patients with hip fracture. | Tao, L. Xiaodong, X. Qiang, M. Jiao, L. Xu, Z. | Ir J Med Sci | 2019 |
Comprehensive geriatric assessment |
| The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. | Sillner, A. Y. Holle, C. L. Rudolph, J. L. | Clin Geriatr Med | 2019 |
Delirium |
| Depth of sedation as an interventional target to reduce postoperative delirium: mortality and functional outcomes of the Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients randomised clinical trial. | Sieber, F. Neufeld, K. J. Gottschalk, A. Bigelow, G. E. Oh, E. S. Rosenberg, P. B. Mears, S. C. Stewart, K. J. Ouanes, J. P. P. Jaberi, M. Hasenboehler, E. A. Wang, N. Y. | British Journal of Anaesthesia | 2019 |
NCT00590707 |
| Delirium Incidence and Functional Outcomes After Transcatheter and Surgical Aortic Valve Replacement. | Shi, S. M. Sung, M. Afilalo, J. Lipsitz, L. A. Kim, C. A. Popma, J. J. Khabbaz, K. R. Laham, R. J. Guibone, K. Lee, J. Marcantonio, E. R. Kim, D. H. | J Am Geriatr Soc | 2019 |
aortic valve replacement |
| Effect of perioperative administration of dexmedetomidine on delirium after cardiac surgery in elderly patients: a double-blinded, multi-center, randomized study. | Shi, C. Jin, J. Qiao, L. Li, T. Ma, J. Ma, Z. | Clin Interv Aging | 2019 |
anesthesia |
| Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses. | Schmitt, E. M. Gallagher, J. Albuquerque, A. Tabloski, P. Lee, H. J. Gleason, L. Weiner, L. S. Marcantonio, E. R. Jones, R. N. Inouye, S. K. Schulman-Green, D. | Gerontologist | 2019 |
*Burden |
| Association of Persistent Intense Thirst With Delirium Among Critically Ill Patients: A Cross-sectional Study. | Sato, K. Okajima, M. Taniguchi, T. | J Pain Symptom Manage | 2019 |
Thirst |
| Role of Epileptic Activity in Older Adults With Delirium, a Prospective Continuous EEG Study. | Sambin, S. Gaspard, N. Legros, B. Depondt, C. De Breucker, S. Naeije, G. | Front Neurol | 2019 |
Ncse |
| Surgical delay is a risk factor of delirium in hip fracture patients with mild–moderate cognitive impairment. | Pioli, G. Bendini, C. Giusti, A. Pignedoli, P. Cappa, M. Iotti, E. Ferri, M. A. Bergonzini, E. Sabetta, E. | Aging Clinical and Experimental Research | 2019 |
age |
| Cerebrospinal Fluid Spermidine, Glutamine and Putrescine Predict Postoperative Delirium Following Elective Orthopaedic Surgery. | Pan, X. Cunningham, E. L. Passmore, A. P. McGuinness, B. McAuley, D. F. Beverland, D. O'Brien, S. Mawhinney, T. Schott, J. M. Zetterberg, H. Green, B. D. | Sci Rep | 2019 | |
| The impact of the Hospital Elder Life Program on the treatment of asymptomatic bacteriuria: An unexpected benefit. | O'Donnell, A. J. Walsh, T. L. Tang, A. Weinberg, L. | Geriatr Nurs | 2019 |
Asymptomatic bacteriuria |
| Continuous EEG Monitoring in a Consecutive Patient Cohort with Sepsis and Delirium. | Nielsen, R. M. Urdanibia-Centelles, O. Vedel-Larsen, E. Thomsen, K. J. Moller, K. Olsen, K. S. Lauritsen, A. O. Eddelien, H. S. Lauritzen, M. Benedek, K. | Neurocrit Care | 2019 |
Brain diseases |
| Delirium risk factors and associated outcomes in a neurosurgical cohort: a case-control study. | Morshed, R. A. Young, J. S. Safaee, M. Sankaran, S. Berger, M. S. McDermott, M. W. Hervey-Jumper, S. L. | World Neurosurg | 2019 |
Delirium |
| Biomarker Predictors of Delirium in Acutely Ill Patients: A Systematic Review. | Michels, M. Michelon, C. Damasio, D. Vitali, A. M. Ritter, C. Dal-Pizzol, F. | J Geriatr Psychiatry Neurol | 2019 |
Cam |
| Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function. | Lindroth, H. Bratzke, L. Twadell, S. Rowley, P. Kildow, J. Danner, M. Turner, L. Hernandez, B. Brown, R. Sanders, R. D. | Int J Geriatr Psychiatry | 2019 |
aging |
| Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke. | Klimiec-Moskal, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T. | European Journal of Neurology | 2019 |
aged |
| SF-36 scores predict postoperative delirium after surgery for cervical spondylotic myelopathy. | Kin, K. Yasuhara, T. Tomita, Y. Umakoshi, M. Morimoto, J. Date, I. | J Neurosurg Spine | 2019 |
CCI = Charlson Comorbidity Index |
| Effects of massage on outcomes of adult intensive care unit patients: a systematic review. | Jagan, S. Park, T. Papathanassoglou, E. | Nurs Crit Care | 2019 |
Complementary and alternative therapies |
| Perioperative Dexmedetomidine Reduces Delirium in Elderly Patients after Lung Cancer Surgery. | Huyan, T. Hu, X. Peng, H. Zhu, Z. Li, Q. Zhang, W. | Psychiatr Danub | 2019 | |
| The Oslo Study of Clonidine in Elderly Patients with Delirium; LUCID: a randomised placebo-controlled trial. | Hov, K. R. Neerland, B. E. Undseth, O. Bruun Bratholm Wyller, V. MacLullich, A. M. J. Qvigstad, E. Skovlund, E. Wyller, T. B. | Int J Geriatr Psychiatry | 2019 |
Delirium treatment |
| Delirium and Alzheimer disease: A proposed model for shared pathophysiology. | Fong, T. G. Vasunilashorn, S. M. Libermann, T. Marcantonio, E. R. Inouye, S. K. | Int J Geriatr Psychiatry | 2019 |
Alzheimer disease |
| Development and validation of a dynamic delirium prediction rule in patients admitted to the Intensive Care Units (DYNAMIC-ICU): A prospective cohort study. | Fan, H. Ji, M. Huang, J. Yue, P. Yang, X. Wang, C. Ying, W. | International journal of nursing studies | 2019 |
aged |
| Delirium and cognitive impairment among older patients in Norwegian emergency departments. | Evensen, S. Saltvedt, I. Ranhoff, A. H. Myrstad, M. Myrstad, C. Mellingsaeter, M. Wang-Hansen, M. S. Neerland, B. E. | Tidsskr Nor Laegeforen | 2019 | |
| Motor activity across delirium motor subtypes in geriatric patients assessed using body-worn sensors: a Norwegian cross-sectional study. | Evensen, S. Bourke, A. K. Lydersen, S. Sletvold, O. Saltvedt, I. Wyller, T. B. Taraldsen, K. | BMJ Open | 2019 |
accelerometer |
| Factors Associated With Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. | Cusimano, J. M. Welch, S. Perez-Protto, S. Lam, S. | Clin Neuropharmacol | 2019 | |
| Intraoperative blood transfusion predicts postoperative delirium among older patients undergoing elective orthopedic surgery: A prospective cohort study. | Chou, M. Y. Wang, Y. C. Peng, L. N. Liang, C. K. Chu, C. S. Liao, M. C. Lin, Y. T. Hsu, C. J. Chen, L. K. | Int J Geriatr Psychiatry | 2019 |
aged |
| Postoperative delirium in critically ill surgical patients: incidence, risk factors, and predictive scores. | Chaiwat, O. Chanidnuan, M. Pancharoen, W. Vijitmala, K. Danpornprasert, P. Toadithep, P. Thanakiattiwibun, C. | BMC Anesthesiology | 2019 |
Intensive care unit (ICU) |
| Differential Clinical Characteristics, Management, and Outcome of Delirium among Ward Compared with ICU Patients. | Canet, E. Amjad, S. Robbins, R. Lewis, J. Matalanis, M. Jones, D. Bellomo, R. | Intern Med J | 2019 |
Agitation |
| Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank. | Bowman, K. Jones, L. Pilling, L. C. Delgado, J. Kuchel, G. A. Ferrucci, L. Fortinsky, R. H. Melzer, D. | Neurology | 2019 | |
| Single-bed rooms in a geriatric ward prevent delirium in older patients. | Blandfort, S. Gregersen, M. Rahbek, K. Juul, S. Damsgaard, E. M. | Aging Clin Exp Res | 2019 |
Delirium |
| Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016. | Aloisi, G. Marengoni, A. Morandi, A. Zucchelli, A. Cherubini, A. Mossello, E. Bo, M. Di Santo, S. G. Mazzone, A. Trabucchi, M. Cappa, S. Fimognari, F. L. Incalzi, R. A. Gareri, P. Perticone, F. Campanini, M. Montorsi, M. Latronico, N. Zambon, A. Bellelli, | J Clin Psychiatry | 2019 | |
| Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017. | Thomas, A. N. Balmforth, J. E. | J Patient Saf | 2019 | |
| Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. | Redley, B. Baker, T. | Journal of Clinical Nursing | 2019 |
acute disease |
| Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients. | Plyler, S. S. Muckler, V. C. Titch, J. F. Gupta, D. K. Rice, A. N. | J Perianesth Nurs | 2019 |
3d-cam |
| Nurses' experiences of caring for older patients afflicted by delirium in a neurological department. | Kristiansen, S. Konradsen, H. Beck, M. | Journal of Clinical Nursing | 2019 |
adult |
| Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-analysis. | Wu, Y. C. Tseng, P. T. Tu, Y. K. Hsu, C. Y. Liang, C. S. Yeh, T. C. Chen, T. Y. Chu, C. S. Matsuoka, Y. J. Stubbs, B. Carvalho, A. F. Wada, S. Lin, P. Y. Chen, Y. W. Su, K. P. | JAMA Psychiatry | 2019 | |
| Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery the engages randomized clinical trial. | Wildes, T. S. Mickle, A. M. Abdallah, A. B. Maybrier, H. R. Oberhaus, J. Budelier, T. P. Kronzer, A. McKinnon, S. L. Park, D. Torres, B. A. Graetz, T. J. Emmert, D. A. Palanca, B. J. Goswami, S. Jordan, K. Lin, N. Fritz, B. A. Stevens, T. W. Jacobsohn, E. | JAMA | 2019 |
NCT02241655 |
| Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial. | Vlisides, P. E. Thompson, A. Kunkler, B. S. Maybrier, H. R. Avidan, M. S. Mashour, G. A. | Anesth Analg | 2019 | |
| Effect of Intravenous Acetaminophen vs Placebo Combined with Propofol or Dexmedetomidine on Postoperative Delirium among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. | Subramaniam, B. Shankar, P. Shaefi, S. Mueller, A. O'Gara, B. Banner-Goodspeed, V. Gallagher, J. Gasangwa, D. Patxot, M. Packiasabapathy, S. Mathur, P. Eikermann, M. Talmor, D. Marcantonio, E. R. | JAMA | 2019 |
NCT02546765 |
| The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery - a retrospective observational study. | Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G. | J Clin Nurs | 2019 |
Assessments scales |
| Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. | Saravana-Bawan, B. Warkentin, L. M. Rucker, D. Carr, F. Churchill, T. A. Khadaroo, R. G. | Canadian Journal of Surgery | 2019 |
aged |
| Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair. | Ravi, B. Pincus, D. Choi, S. Jenkinson, R. Wasserstein, D. N. Redelmeier, D. A. | JAMA Netw Open | 2019 | |
| Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study. | Oldham, M. A. Hawkins, K. A. Lin, I. H. Deng, Y. Hao, Q. Scoutt, L. M. Yuh, D. D. Lee, H. B. | American Journal of Geriatric Psychiatry | 2019 |
aged |
| Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. | Neefjes, E. C. W. van der Vorst, Mjdl Boddaert, M. S. A. Verdegaal, Batt Beeker, A. Teunissen, S. C. C. Beekman, A. T. F. Zuurmond, W. W. A. Berkhof, J. Verheul, H. M. W. | BMC Cancer | 2019 |
Delirium |
| The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study. | Nagae, M. Egi, M. Furushima, N. Okada, M. Makino, S. Mizobuchi, S. | J Anesth | 2019 |
Delirium |
| Association between delirium, adverse clinical events and functional outcomes in older patients admitted to rehabilitation settings after a hip fracture: A multicenter retrospective cohort study. | Morandi, A. Mazzone, A. Bernardini, B. Suardi, T. Prina, R. Pozzi, C. Gentile, S. Trabucchi, M. Bellelli, G. | Geriatrics & Gerontology International | 2019 |
aged |
| Handover of anesthesia care is associated with an increased risk of delirium in elderly after major noncardiac surgery: results of a secondary analysis. | Liu, G. Y. Su, X. Meng, Z. T. Cui, F. Li, H. L. Zhu, S. N. Wang, D. X. | J Anesth | 2019 |
Delirium |
| Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital. | Lange, P. W. Lamanna, M. Watson, R. Maier, A. B. | J Clin Nurs | 2019 |
Undiagnosed delirium |