Neurology

Vitamin D: A novel protective factor for delirium?

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

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