Systemic oxidative stress associates with delirium in a geriatric population with hip fracture
Background: Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, actin...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | Experimental Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556525001305 |
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| author | Monika Trzpis Maria Zernova Karin M. Vermeulen Marian L.C. Bulthuis Marjan Reinders-Luinge Harry van Goor Barbara C. van Munster Arno R. Bourgonje |
| author_facet | Monika Trzpis Maria Zernova Karin M. Vermeulen Marian L.C. Bulthuis Marjan Reinders-Luinge Harry van Goor Barbara C. van Munster Arno R. Bourgonje |
| author_sort | Monika Trzpis |
| collection | DOAJ |
| description | Background: Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, acting as potent antioxidants. We aimed to investigate the relationship between delirium and systemic oxidative stress in older patients hospitalized with hip fracture. Methods: Patients aged 65 years or more, acutely admitted due to hip fracture, were included between 2005 and 2008. Delirium was diagnosed according to the DSM-IV criteria for delirium. Free thiols were determined in plasma samples that had been collected longitudinally during hospitalization for previous clinical trial, using colorimetric detection. Albumin-adjusted plasma free thiol concentrations were both cross-sectionally and longitudinally evaluated in relation to delirium. Results: In total 813 plasma samples from 336 patients were analysed. Delirium was experienced by 110 (33 %) patients. Mean albumin-adjusted free thiols of patients who experienced delirium (7.3 ± SD 1.4 μM/g) was lower than that of non-delirious patients (7.5 ± SD 1.3 μM/g) (P = 0.050). Multivariable logistic regression analysis, adjusted for age, preexisting cognitive impairment, institutionalization, time to surgery, and complications, indicated that delirium was significantly inversely associated with albumin-adjusted free thiol concentrations (OR = 0.8, 95%CI 0.75–0.96). The significant association between delirium and albumin-adjusted free thiols tested in all the samples was also shown by linear mixed model analysis after adjusting for confounders (β = −0.292; 95%CI 0.04–0.55). Conclusions: Reduced concentrations of free thiols, reflecting systemic oxidative stress, are associated with delirium onset among patients with hip fracture. |
| format | Article |
| id | doaj-art-ea131c948705499c8de3f4c7cdfa18b2 |
| institution | OA Journals |
| issn | 1873-6815 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj-art-ea131c948705499c8de3f4c7cdfa18b22025-08-20T02:05:07ZengElsevierExperimental Gerontology1873-68152025-08-0120711280110.1016/j.exger.2025.112801Systemic oxidative stress associates with delirium in a geriatric population with hip fractureMonika Trzpis0Maria Zernova1Karin M. Vermeulen2Marian L.C. Bulthuis3Marjan Reinders-Luinge4Harry van Goor5Barbara C. van Munster6Arno R. Bourgonje7Department of Internal Medicine, The University Center for Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Alzheimer Centrum Groningen, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Corresponding authors at: University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, P.O. Box 30.001, Groningen, the Netherlands.Department of Internal Medicine, The University Center for Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Internal Medicine, The University Center for Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsAlzheimer Centrum Groningen, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Geriatric Medicine, Martini Hospital, Groningen, the NetherlandsDepartment of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Corresponding authors at: University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, P.O. Box 30.001, Groningen, the Netherlands.Background: Oxidative stress ensues in patients undergoing surgery for hip fracture and has been implicated in the pathophysiology of delirium. Circulating free thiols (R-SH, sulfhydryl groups) serve as biomarker of systemic oxidative stress since they are rapidly oxidized by reactive species, acting as potent antioxidants. We aimed to investigate the relationship between delirium and systemic oxidative stress in older patients hospitalized with hip fracture. Methods: Patients aged 65 years or more, acutely admitted due to hip fracture, were included between 2005 and 2008. Delirium was diagnosed according to the DSM-IV criteria for delirium. Free thiols were determined in plasma samples that had been collected longitudinally during hospitalization for previous clinical trial, using colorimetric detection. Albumin-adjusted plasma free thiol concentrations were both cross-sectionally and longitudinally evaluated in relation to delirium. Results: In total 813 plasma samples from 336 patients were analysed. Delirium was experienced by 110 (33 %) patients. Mean albumin-adjusted free thiols of patients who experienced delirium (7.3 ± SD 1.4 μM/g) was lower than that of non-delirious patients (7.5 ± SD 1.3 μM/g) (P = 0.050). Multivariable logistic regression analysis, adjusted for age, preexisting cognitive impairment, institutionalization, time to surgery, and complications, indicated that delirium was significantly inversely associated with albumin-adjusted free thiol concentrations (OR = 0.8, 95%CI 0.75–0.96). The significant association between delirium and albumin-adjusted free thiols tested in all the samples was also shown by linear mixed model analysis after adjusting for confounders (β = −0.292; 95%CI 0.04–0.55). Conclusions: Reduced concentrations of free thiols, reflecting systemic oxidative stress, are associated with delirium onset among patients with hip fracture.http://www.sciencedirect.com/science/article/pii/S0531556525001305Oxidative stressDeliriumFree thiolsGeriatricsPathophysiology |
| spellingShingle | Monika Trzpis Maria Zernova Karin M. Vermeulen Marian L.C. Bulthuis Marjan Reinders-Luinge Harry van Goor Barbara C. van Munster Arno R. Bourgonje Systemic oxidative stress associates with delirium in a geriatric population with hip fracture Experimental Gerontology Oxidative stress Delirium Free thiols Geriatrics Pathophysiology |
| title | Systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| title_full | Systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| title_fullStr | Systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| title_full_unstemmed | Systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| title_short | Systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| title_sort | systemic oxidative stress associates with delirium in a geriatric population with hip fracture |
| topic | Oxidative stress Delirium Free thiols Geriatrics Pathophysiology |
| url | http://www.sciencedirect.com/science/article/pii/S0531556525001305 |
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