{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:00:41Z","timestamp":1790100041443,"version":"4.0.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Z Gerontol Geriat"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s00391-026-02638-2","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T19:36:13Z","timestamp":1788550573000},"page":"467-472","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathophysiology and biomarkers of delirium in older adults\u2014Narrative review","Pathophysiologie und Biomarker des Delirs bei \u00e4lteren Erwachsenen\u00a0\u2013 narrativer Review"],"prefix":"10.1007","volume":"59","author":[{"given":"Fatima","family":"Irfan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Jorke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine A. F.","family":"von Arnim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2638_CR1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"Association AP","year":"2022","unstructured":"American Psychiatric Association (2022) Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, Fifth Edition, Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC. https:\/\/doi.org\/10.1176\/appi.books.9780890425787"},{"key":"2638_CR2","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s00401-010-0674-1","volume":"119","author":"J Cerejeira","year":"2010","unstructured":"Cerejeira\u00a0J, Firmino\u00a0H, Vaz-Serra\u00a0A et\u00a0al (2010) The neuroinflammatory hypothesis of delirium. Acta neuropathologica 119:737\u2013754. https:\/\/doi.org\/10.1007\/s00401-010-0674-1","journal-title":"Acta neuropathologica"},{"key":"2638_CR3","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.6370","volume":"157","author":"F Deeken","year":"2022","unstructured":"Deeken\u00a0F, S\u00e1nchez\u00a0A, Rapp\u00a0MA et\u00a0al (2022) Outcomes of a Delirium Prevention Program in Older Persons After Elective Surgery: A Stepped-Wedge Cluster Randomized Clinical Trial. JAMA Surg 157:e216370. https:\/\/doi.org\/10.1001\/jamasurg.2021.6370","journal-title":"JAMA surgery"},{"key":"2638_CR4","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.679933","volume":"13","author":"GW Eschweiler","year":"2021","unstructured":"Eschweiler\u00a0GW, Czornik\u00a0M, Herrmann\u00a0ML et\u00a0al (2021) Presurgical Screening Improves Risk Prediction for Delirium in Elective Surgery of Older Patients: The PAWEL RISK Study. Front Aging Neurosci 13:679933. https:\/\/doi.org\/10.3389\/fnagi.2021.679933","journal-title":"Frontiers in aging neuroscience"},{"key":"2638_CR5","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1097\/ALN.0000000000005722","volume":"144","author":"BF Gruenbaum","year":"2026","unstructured":"Gruenbaum\u00a0BF, Zlotnik\u00a0A, Dubilet\u00a0M et\u00a0al (2026) Role of Blood-Brain Barrier Permeability in Delirium Pathophysiology and Treatment. Anesthesiology 144:203\u2013229. https:\/\/doi.org\/10.1097\/ALN.0000000000005722","journal-title":"Anesthesiology"},{"key":"2638_CR6","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.1038\/s41380-025-03412-3","volume":"31","author":"N Hansen","year":"2026","unstructured":"Hansen\u00a0N, Knopp\u00a0CM, Esselmann\u00a0H et\u00a0al (2026) Prediction of postoperative delirium after cardiac surgery by the interplay between preoperative plasma p\u2011tau181 and IL\u20116 and heart-brain axis related factors: results from the prospective observational study FINDERI. Mol Psychiatry 31:2509\u20132519. https:\/\/doi.org\/10.1038\/s41380-025-03412-3","journal-title":"Molecular psychiatry"},{"key":"2638_CR7","doi-asserted-by":"publisher","DOI":"10.1002\/alz.71631","volume":"22","author":"N Hansen","year":"2026","unstructured":"Hansen\u00a0N, Sadlonova\u00a0M, Esselmann\u00a0H et\u00a0al (2026) Early Alzheimer\u2019s disease blood biomarkers are associated with a higher risk for postoperative long-term cognitive decline: Insights from the FINDERI study. Alzheimers Dement 22:e71631. https:\/\/doi.org\/10.1002\/alz.71631","journal-title":"Alzheimer\u2019s & dementia : the journal of the Alzheimer\u2019s Association"},{"key":"2638_CR8","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcab121","volume":"3","author":"K Henjum","year":"2021","unstructured":"Henjum\u00a0K, Godang\u00a0K, Quist-Paulsen\u00a0E et\u00a0al (2021) Cerebrospinal fluid catecholamines in delirium and dementia. Brain Commun 3:fcab121. https:\/\/doi.org\/10.1093\/braincomms\/fcab121","journal-title":"Brain communications"},{"key":"2638_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1702862","volume":"16","author":"XY Li","year":"2025","unstructured":"Li\u00a0XY, Yang\u00a0JY, Qiu\u00a0Y et\u00a0al (2025) Dexmedetomidine for postoperative delirium in surgical patients: a\u00a0mini-review of mechanisms, clinical evidence, and practical implementation. Front Pharmacol 16:1702862. https:\/\/doi.org\/10.3389\/fphar.2025.1702862","journal-title":"Frontiers in pharmacology"},{"key":"2638_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2026.1728476","volume":"17","author":"QX Liang","year":"2026","unstructured":"Liang\u00a0QX, Tan\u00a0XL, Huang\u00a0ZW et\u00a0al (2026) Meta-analysis for the associations of serum C\u2011reactive protein with delirium risk. Front Neurol 17:1728476. https:\/\/doi.org\/10.3389\/fneur.2026.1728476","journal-title":"Frontiers in neurology"},{"key":"2638_CR11","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1002\/gps.4823","volume":"33","author":"JR Maldonado","year":"2018","unstructured":"Maldonado\u00a0JR (2018) Delirium pathophysiology: An updated hypothesis of the etiology of acute brain failure. Int J Geriatr Psychiatry 33:1428\u20131457. https:\/\/doi.org\/10.1002\/gps.4823","journal-title":"International journal of geriatric psychiatry"},{"key":"2638_CR12","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s00415-025-13145-6","volume":"272","author":"TB McKay","year":"2025","unstructured":"McKay\u00a0TB, Smith\u00a0M, Mueller\u00a0A et\u00a0al (2025) Associations between A\u03b240, A\u03b242, and tau and postoperative delirium in older adults undergoing cardiac surgery. J\u00a0Neurol 272:393. https:\/\/doi.org\/10.1007\/s00415-025-13145-6","journal-title":"Journal of neurology"},{"key":"2638_CR13","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.70979","volume":"15","author":"HC Moorey","year":"2025","unstructured":"Moorey\u00a0HC, McCluskey-White\u00a0LM, Andleeb\u00a0S et\u00a0al (2025) A Systematic Review and Meta-Analysis of the Role of Peripheral Inflammation in Delirium. Brain Behav 15:e70979. https:\/\/doi.org\/10.1002\/brb3.70979","journal-title":"Brain and behavior"},{"key":"2638_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-82992-6","volume":"15","author":"MP Mosharaf","year":"2025","unstructured":"Mosharaf\u00a0MP, Alam\u00a0K, Gow\u00a0J et\u00a0al (2025) Cytokines and inflammatory biomarkers and their association with post-operative delirium: a\u00a0meta-analysis and systematic review. Sci Rep 15:7830. https:\/\/doi.org\/10.1038\/s41598-024-82992-6","journal-title":"Scientific reports"},{"key":"2638_CR15","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02986-w","volume":"14","author":"Y Nishizawa","year":"2024","unstructured":"Nishizawa\u00a0Y, Thompson\u00a0KC, Yamanashi\u00a0T et\u00a0al (2024) Epigenetic signals associated with delirium replicated across four independent cohorts. Transl Psychiatry 14:275. https:\/\/doi.org\/10.1038\/s41398-024-02986-w","journal-title":"Translational psychiatry"},{"issue":"18","key":"2638_CR16","doi-asserted-by":"publisher","first-page":"9062","DOI":"10.3390\/ijms26189062","volume":"26","author":"K Nowakowska","year":"2025","unstructured":"Nowakowska\u00a0K, Walkiewicz\u00a0G, Stec-Martyna\u00a0E et\u00a0al (2025) Circulating Brain-Related miRNAs as Predictors of Postoperative Delirium in Cardiac Surgery Patients. International Journal of Molecular Sciences 26(18):9062. https:\/\/doi.org\/10.3390\/ijms26189062","journal-title":"International journal of molecular sciences"},{"key":"2638_CR17","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1093\/gerona\/glab203","volume":"77","author":"M Parker","year":"2022","unstructured":"Parker\u00a0M, White\u00a0M, Casey\u00a0C et\u00a0al (2022) Cohort Analysis of the Association of Delirium Severity With Cerebrospinal Fluid Amyloid-Tau-Neurodegeneration Pathologies. J\u00a0Gerontol A Biol Sci Med Sci 77:494\u2013501. https:\/\/doi.org\/10.1093\/gerona\/glab203","journal-title":"The journals of gerontology. Series A, Biological sciences and medical sciences"},{"key":"2638_CR18","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/j.jagp.2023.12.017","volume":"32","author":"M Sadlonova","year":"2024","unstructured":"Sadlonova\u00a0M, Hansen\u00a0N, Esselmann\u00a0H et\u00a0al (2024) Preoperative Delirium Risk Screening in Patients Undergoing a\u00a0Cardiac Surgery: Results from the Prospective Observational FINDERI Study. Am J Geriatr Psychiatry 32:835\u2013851. https:\/\/doi.org\/10.1016\/j.jagp.2023.12.017","journal-title":"The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry"},{"key":"2638_CR19","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.neurobiolaging.2020.06.003","volume":"94","author":"T Saito","year":"2020","unstructured":"Saito\u00a0T, Braun\u00a0PR, Daniel\u00a0S et\u00a0al (2020) The relationship between DNA methylation in neurotrophic genes and age as evidenced from three independent cohorts: differences by delirium status. Neurobiol Aging 94:227\u2013235. https:\/\/doi.org\/10.1016\/j.neurobiolaging.2020.06.003","journal-title":"Neurobiology of aging"},{"issue":"3","key":"2638_CR20","doi-asserted-by":"publisher","first-page":"afag068","DOI":"10.1093\/ageing\/afag068","volume":"55","author":"A S\u00e1nchez","year":"2026","unstructured":"S\u00e1nchez\u00a0A, Sawant-Uttekar\u00a0P, Heinen\u00a0D et\u00a0al (2026) Effectiveness of non-pharmacological and pharmacological interventions in preventing delirium in older adults: a\u00a0systematic review and meta-analysis of randomised controlled trials. Age Ageing 55(3):afag068. https:\/\/doi.org\/10.1093\/ageing\/afag068","journal-title":"Age and ageing"},{"key":"2638_CR21","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214833","volume":"106","author":"KR Sewell","year":"2026","unstructured":"Sewell\u00a0KR, Solis-Urra\u00a0P, Huang\u00a0H et\u00a0al (2026) Cognitive and Brain Reserve as Modifiers of Early Alzheimer Disease-Related Cognitive Vulnerability. Neurology 106:e214833. https:\/\/doi.org\/10.1212\/WNL.0000000000214833","journal-title":"Neurology"},{"key":"2638_CR22","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a041197","author":"A Singh","year":"2024","unstructured":"Singh\u00a0A, Schurman\u00a0SH, Bektas\u00a0A et\u00a0al (2024) Aging and Inflammation. Cold Spring Harbor perspectives in medicine (6):a041197. https:\/\/doi.org\/10.1101\/cshperspect.a041197","journal-title":"Cold Spring Harbor perspectives in medicine"},{"key":"2638_CR23","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1055\/s-0044-1791666","volume":"44","author":"CJ Smith","year":"2024","unstructured":"Smith\u00a0CJ, Hodge\u00a0D, Harrison\u00a0FE et\u00a0al (2024) The Pathophysiology and Biomarkers of Delirium. Seminars in neurology 44:720\u2013731. https:\/\/doi.org\/10.1055\/s-0044-1791666","journal-title":"Seminars in neurology"},{"key":"2638_CR24","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000729","volume":"4","author":"RJ Smith","year":"2022","unstructured":"Smith\u00a0RJ, Rabinstein\u00a0AA, Cartin-Ceba\u00a0R et\u00a0al (2022) Chemokines in ICU Delirium: An Exploratory Study. Critical care explorations 4:e0729. https:\/\/doi.org\/10.1097\/CCE.0000000000000729","journal-title":"Critical care explorations"},{"key":"2638_CR25","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1089\/rej.2011.1185","volume":"14","author":"BC van Munster","year":"2011","unstructured":"van Munster\u00a0BC, Aronica\u00a0E, Zwinderman\u00a0AH et\u00a0al (2011) Neuroinflammation in delirium: a postmortem case-control study. Rejuvenation research 14:615\u2013622. https:\/\/doi.org\/10.1089\/rej.2011.1185","journal-title":"Rejuvenation research"},{"key":"2638_CR26","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1093\/gerona\/glv083","volume":"70","author":"SM Vasunilashorn","year":"2015","unstructured":"Vasunilashorn\u00a0SM, Ngo\u00a0L, Inouye\u00a0SK et\u00a0al (2015) Cytokines and Postoperative Delirium in Older Patients Undergoing Major Elective Surgery. J\u00a0Gerontol A Biol Sci Med Sci 70:1289\u20131295. https:\/\/doi.org\/10.1093\/gerona\/glv083","journal-title":"The journals of gerontology. Series A, Biological sciences and medical sciences"},{"key":"2638_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-00223-4","volume":"6","author":"JE Wilson","year":"2020","unstructured":"Wilson\u00a0JE, Mart\u00a0MF, Cunningham\u00a0C et\u00a0al (2020) Delirium. Nat Rev Dis Primers 6:90. https:\/\/doi.org\/10.1038\/s41572-020-00223-4","journal-title":"Nature reviews. Disease primers"},{"issue":"7","key":"2638_CR28","doi-asserted-by":"publisher","first-page":"glaf058","DOI":"10.1093\/gerona\/glaf058","volume":"80","author":"L Wu","year":"2025","unstructured":"Wu\u00a0L, Su\u00a0J, Li\u00a0G et\u00a0al (2025) Preoperative Plasma p\u2011tau231, p\u2011tau181, and p\u2011tau217 Are Associated With Postoperative Delirium: A Prospective Study. J\u00a0Gerontol A Biol Sci Med Sci 80(7):glaf058. https:\/\/doi.org\/10.1093\/gerona\/glaf058","journal-title":"The journals of gerontology. Series A, Biological sciences and medical sciences"},{"key":"2638_CR29","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1186\/s12877-026-07717-y","volume":"26","author":"YW Yang","year":"2026","unstructured":"Yang\u00a0YW, Zhang\u00a0Y, Qu\u00a0TY et\u00a0al (2026) Perioperative neurofilament light chain and glial fibrillary acidic protein as biomarkers of postoperative delirium: a systematic review and meta-analysis. BMC Geriatr 26:870. https:\/\/doi.org\/10.1186\/s12877-026-07717-y","journal-title":"BMC geriatrics"},{"key":"2638_CR30","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-80739-x","volume":"14","author":"T Yuba","year":"2024","unstructured":"Yuba\u00a0T, Koyama\u00a0Y, Takahashi\u00a0A et\u00a0al (2024) Association between oxidative stress and postoperative delirium in joint replacement using diacron-reactive oxygen metabolites and biological antioxidant potential tests. Sci Rep 14:29854. https:\/\/doi.org\/10.1038\/s41598-024-80739-x","journal-title":"Scientific reports"},{"key":"2638_CR31","doi-asserted-by":"publisher","first-page":"11517","DOI":"10.1038\/s41598-026-41714-w","volume":"16","author":"L Zhang","year":"2026","unstructured":"Zhang\u00a0L, Zhang\u00a0X, Wang\u00a0Q et\u00a0al (2026) The stress hyperglycemia ratio as a novel risk marker for postoperative delirium after cardiac valve surgery. Sci Rep 16:11517. https:\/\/doi.org\/10.1038\/s41598-026-41714-w","journal-title":"Scientific reports"}],"container-title":["Zeitschrift f\u00fcr Gerontologie und Geriatrie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00391-026-02638-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00391-026-02638-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00391-026-02638-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:04:35Z","timestamp":1790096675000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00391-026-02638-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["2638"],"URL":"https:\/\/doi.org\/10.1007\/s00391-026-02638-2","relation":{},"ISSN":["0948-6704","1435-1269"],"issn-type":[{"value":"0948-6704","type":"print"},{"value":"1435-1269","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"assertion":[{"value":"18 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"C.A.F.\u00a0von Arnim received honoraria for serving on the scientific advisory board of Biogen, Roche, Novo Nordisk, Biontech, Lilly, Dr. Willmar Schwabe GmbH &Co. KG, RoX Health GmbH, Bosch Health Campus, and MindAhead UG and has received funding for travel and speaker honoraria from Lilly, Novo Nordisk, Roche, Novartis, Medical Tribune Verlagsgesellschaft mbH, Landesvereinigung f\u00fcr Gesundheit und Akademie f\u00fcr Sozialmedizin Niedersachsen e.\u202fV., FomF GmbH | Forum f\u00fcr medizinische Fortbildung and Dr. Willmar Schwabe GmbH &Co. KG and research funding from the Innovationsfond (Fund of the Federal Joint Committee, Gemeinsamer Bundesausschuss, G\u2011BA Grants No. VF1_2016-201; 01NVF21010; 01VSF21019). DFG (GRK 2824: RP9; 540861493). Development of S3-guidelines: on \u201cDelirium in older adults\u201d (Deleihla) (Konsortialpartner, Fund of the Federal Joint Committee, Gemeinsamer Bundesausschuss, G\u2011BA Grant No. 01VSF21019), on \u201cDementia\u201d (Member of the expert group), and on \u201cMenopause\u201d (DGN representative). F.\u00a0Irfan, J.\u00a0Jorke and N.\u00a0Hansen declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this article no studies with human participants or animals were performed by any of the authors. This article is a narrative review and does therefore not require ethics approval and informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}}]}}