Vitamin D

Delirium is a state of acute brain dysfunction, affecting as many as 50% of older patients in hospital, and is associated with prolonged hospitalization, high health care costs, long-term cognitive decline and dementia, and a substantially increased risk of mortality.1–3 One postulated mechanism is that delirium results from the breakdown of brain network dynamics triggered by a stressor (e.g., major surgery, general anesthesia, infections, or psychoactive drugs) in individuals with preexisting low brain resilience due to deficits in connectivity or plasticity.2 Multiple lines of evidence support a strong relationship between delirium and dementia and that these conditions share some pathophysiologic mechanisms, including acetylcholine deficiency, inflammation, and reduced cerebral oxidative metabolism.3

[1]  T. Müller,et al.  Vitamin D rise enhances blood perfusion in patients with multiple sclerosis , 2019, Journal of Neural Transmission.

[2]  D. Melzer,et al.  Vitamin D levels and risk of delirium , 2019, Neurology.

[3]  S. Larsson,et al.  Serum Parathyroid Hormone, 25-Hydroxyvitamin D, and Risk of Alzheimer’s Disease: A Mendelian Randomization Study , 2018, Nutrients.

[4]  P. O’Reilly,et al.  Genome-wide association study in 79,366 European-ancestry individuals informs the genetic architecture of 25-hydroxyvitamin D levels , 2018, Nature Communications.

[5]  S. Larsson,et al.  Modifiable pathways in Alzheimer’s disease: Mendelian randomisation analysis , 2017, British Medical Journal.

[6]  Á. Pascual-Leone,et al.  Advancing the Neurophysiological Understanding of Delirium , 2017, Journal of the American Geriatrics Society.

[7]  S. Inouye,et al.  The interface between delirium and dementia in elderly adults , 2015, The Lancet Neurology.

[8]  E. Giovannucci,et al.  Association between pre-hospital vitamin D status and hospital-acquired new-onset delirium. , 2015, The British journal of nutrition.

[9]  T. Littlejohns,et al.  ‘Vitamin D and cognition in older adults’: updated international recommendations , 2015, Journal of internal medicine.

[10]  J. Saczynski,et al.  Delirium in elderly people , 2014, The Lancet.

[11]  M. Speeckaert,et al.  Vitamin D binding protein: a multifunctional protein of clinical importance. , 2014, Advances in clinical chemistry.