Fitter individuals are at the highest risk of death associated with delirium

Melanie Dani is a trainee in geriatric medicine in the North West Thames deanery. She is also completing a PhD at Imperial College London studying biomarkers in Alzheimer’s Disease, and has an interest in cognition and dementia.

It is well-recognised that delirium is associated with increased mortality. It’s less clear, though, whether this is the case across the spectrum of frailty. There is an idea that delirium might have bimodal outcomes – worse in frailer people, but may be protective in fitter individuals by highlighting an underlying problem early and (potentially) prompting earlier treatment.

While past studies have accounted for chronic diseases and acute illness severity, few have accounted for both. We wanted to see whether the associations of delirium with mortality remained so even after accounting for acute and chronic health factors, so we modelled both these together in a frailty index. This included 31 variables encompassing chronic disease, acute illness parameters, and functional status and was applied in a large cohort of acute medical older inpatients. Continue reading

Mitochondria, mobility and ageing

Amanda Natanek is a Clinical Senior Lecturer at Imperial College London and a Consultant Physician at the Royal Brompton and Harefield NHS Foundation Trust. She is raising awareness of the clinical relevance of mitochondrial function and the oxidative capacity of skeletal muscle in conditions associated with ageing, by holding the first international symposium on this topic next month.

amandaMitochondria are fascinating organelles. Thought to have originated as aerobic bacteria that became engulfed by primitive eukaryotic cells, they are the ‘powerhouse’ of the cell. By generating ATP efficiently through a chain of oxygen-requiring reactions, they fuel the multitude of active processes that keep the cell ticking over. When a cell’s time is up, mitochondria are triggers of cell death. Continue reading