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Serum anticholinergic activity and cerebral cholinergic dysfunction: an EEG study in frail elderly with and without delirium.
BMC Neurosci. 2008 Sep 15; 9:86.BN

Abstract

BACKGROUND

Delirium increases morbidity, mortality and healthcare costs especially in the elderly. Serum anticholinergic activity (SAA) is a suggested biomarker for anticholinergic burden and delirium risk, but the association with cerebral cholinergic function remains unclear. To clarify this relationship, we prospectively assessed the correlation of SAA with quantitative electroencephalography (qEEG) power, delirium occurrence, functional and cognitive measures in a cross-sectional sample of acutely hospitalized elderly (> 80 y) with high dementia and delirium prevalence.

METHODS

61 consecutively admitted patients over 80 years underwent an extensive clinical and neuropsychological evaluation. SAA was determined by using radio receptor assay as developed by Tune, and standard as well as quantitative EEGs were obtained.

RESULTS

15 patients had dementia with additional delirium (DD) according to expert consensus using DSM-IV criteria, 31 suffered from dementia without delirium (D), 15 were cognitively unimpaired (CU). SAA was clearly detectable in all patients but one (mean 10.9 +/- 7.1 pmol/ml), but was not associated with expert-panel approved delirium diagnosis or cognitive functions. Delirium-associated EEG abnormalities included occipital slowing, peak power and alpha decrease, delta and theta power increase and slow wave ratio increase during active delirious states. EEG measures correlated significantly with cognitive performance and delirium severity, but not with SAA levels.

CONCLUSION

In elderly with acute disease, EEG parameters reliable indicate delirium, but SAA does not seem to reflect cerebral cholinergic function as measured by EEG and is not related to delirium diagnosis.

Authors+Show Affiliations

Centre for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr, Heidelberg, Germany. Christine.Thomas@evkb.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18793418

Citation

Thomas, Christine, et al. "Serum Anticholinergic Activity and Cerebral Cholinergic Dysfunction: an EEG Study in Frail Elderly With and Without Delirium." BMC Neuroscience, vol. 9, 2008, p. 86.
Thomas C, Hestermann U, Kopitz J, et al. Serum anticholinergic activity and cerebral cholinergic dysfunction: an EEG study in frail elderly with and without delirium. BMC Neurosci. 2008;9:86.
Thomas, C., Hestermann, U., Kopitz, J., Plaschke, K., Oster, P., Driessen, M., Mundt, C., & Weisbrod, M. (2008). Serum anticholinergic activity and cerebral cholinergic dysfunction: an EEG study in frail elderly with and without delirium. BMC Neuroscience, 9, 86. https://doi.org/10.1186/1471-2202-9-86
Thomas C, et al. Serum Anticholinergic Activity and Cerebral Cholinergic Dysfunction: an EEG Study in Frail Elderly With and Without Delirium. BMC Neurosci. 2008 Sep 15;9:86. PubMed PMID: 18793418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum anticholinergic activity and cerebral cholinergic dysfunction: an EEG study in frail elderly with and without delirium. AU - Thomas,Christine, AU - Hestermann,Ute, AU - Kopitz,Juergen, AU - Plaschke,Konstanze, AU - Oster,Peter, AU - Driessen,Martin, AU - Mundt,Christoph, AU - Weisbrod,Matthias, Y1 - 2008/09/15/ PY - 2008/03/01/received PY - 2008/09/15/accepted PY - 2008/9/17/pubmed PY - 2008/12/17/medline PY - 2008/9/17/entrez SP - 86 EP - 86 JF - BMC neuroscience JO - BMC Neurosci VL - 9 N2 - BACKGROUND: Delirium increases morbidity, mortality and healthcare costs especially in the elderly. Serum anticholinergic activity (SAA) is a suggested biomarker for anticholinergic burden and delirium risk, but the association with cerebral cholinergic function remains unclear. To clarify this relationship, we prospectively assessed the correlation of SAA with quantitative electroencephalography (qEEG) power, delirium occurrence, functional and cognitive measures in a cross-sectional sample of acutely hospitalized elderly (> 80 y) with high dementia and delirium prevalence. METHODS: 61 consecutively admitted patients over 80 years underwent an extensive clinical and neuropsychological evaluation. SAA was determined by using radio receptor assay as developed by Tune, and standard as well as quantitative EEGs were obtained. RESULTS: 15 patients had dementia with additional delirium (DD) according to expert consensus using DSM-IV criteria, 31 suffered from dementia without delirium (D), 15 were cognitively unimpaired (CU). SAA was clearly detectable in all patients but one (mean 10.9 +/- 7.1 pmol/ml), but was not associated with expert-panel approved delirium diagnosis or cognitive functions. Delirium-associated EEG abnormalities included occipital slowing, peak power and alpha decrease, delta and theta power increase and slow wave ratio increase during active delirious states. EEG measures correlated significantly with cognitive performance and delirium severity, but not with SAA levels. CONCLUSION: In elderly with acute disease, EEG parameters reliable indicate delirium, but SAA does not seem to reflect cerebral cholinergic function as measured by EEG and is not related to delirium diagnosis. SN - 1471-2202 UR - https://www.unboundmedicine.com/medline/citation/18793418/Serum_anticholinergic_activity_and_cerebral_cholinergic_dysfunction:_an_EEG_study_in_frail_elderly_with_and_without_delirium_ L2 - https://bmcneurosci.biomedcentral.com/articles/10.1186/1471-2202-9-86 DB - PRIME DP - Unbound Medicine ER -