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

Glutamate concentration was higher in parietal white matter in patients with delirium compared to those without delirium.

• Finding was obtained using a General Linear Model incorporating the MRS voxel ADC to account for white matter lesion effects.
• The difference in glutamate was statistically significant (P = 0.024).
• Delirium group n = 13, non-delirium group n = 12.
• No other between-group differences in metabolite concentrations were observed.

Patients with delirium had greater pre-admission frailty than those without delirium.

• Frailty was assessed using the Clinical Frailty Scale.
• Median Clinical Frailty Scale was 5 in delirium patients versus 4.5 in non-delirium patients.
• The difference was statistically significant (P = .049).
• There were no significant differences between groups in age, sex, measures of MRS quality, atrophy, or white matter disease.

Glutamine concentration increased with age and decreased with cortical atrophy across the combined patient sample.

• This finding was observed across patients with and without delirium combined (n = 25).
• Glutamine decreased with cortical atrophy.
• Glutamine increased with age.
• No specific p-values or effect sizes were reported for these associations in the abstract.

Myo-inositol concentration decreased with age and increased with median apparent diffusion coefficient (ADC) across the combined patient sample.

• This finding was observed across patients with and without delirium combined (n = 25).
• Myo-inositol decreased with age.
• Myo-inositol increased with median ADC, a measure reflecting white matter microstructural changes.
• No specific p-values or effect sizes were reported for these associations in the abstract.

A prospective case-control MRS study of hospitalised older people was conducted with metabolite concentrations measured in parietal white matter.

• Medical inpatients aged ≥65 with and without delirium (DSM-5 criteria) were recruited.
• Participants were assessed for illness severity, frailty, and prior cognitive decline.
• Out of 38 recruited participants, 25 completed the MRS protocol (13 males and 12 females, mean age 80.5, SD = 6.47).
• Diffusion MRI was used to assess structural changes via the apparent diffusion coefficient (ADC).