Development of a new delirium prediction score using biomarkers

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K19046
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: Tohoku University
• Principal Investigator: SAKUMA Atsushi 東北大学, 大学病院, 助教 (90733759)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: せん妄 / バイオマーカー / 抑うつ / 不眠

Outline of Final Research Achievements

It has been pointed out that the development of delirium may be influenced by a combination of patient background factors such as advanced age, cognitive decline, history of alcohol consumption, and use of sleeping pills, as well as psychiatric symptoms such as depression and insomnia, and biomarkers such as inflammatory response and electrolyte abnormalities. However, in the aging Japanese society, there is a lack of composite indicators that can be easily utilized in clinical practice. In this study, we asked patients with cancer to wear an activity meter, the ACTIGRAPH, during hospitalization to assess their psychiatric symptoms and to explore indicators associated with psychiatric symptoms, including delirium. The results revealed that a decrease in the amount of activity that can be measured by the actigraph may be associated with the onset of psychiatric symptoms.

Free Research Field

精神医学

Academic Significance and Societal Importance of the Research Achievements

身体疾患の治療中にせん妄や精神症状（抑うつや不眠）を発症すると、予後が悪化したり、認知症を発症する危険性が高まることが指摘されてきました。リスクが高い方に重点的な支援を提供し予防することが理想ですが、高齢化が著しい本邦では大半の入院症例がハイリスクに該当してしまうため、真にケアを要する患者が識別可能な客観的指標が求められてきました。本研究により、活動量計であるアクチグラフで計測可能な日中の活動量の低下が、せん妄リスクを高める抑うつの発症と関連する可能性が示唆されました。入院後に低下しやすい活動量の低下を予防することが精神症状を改善し、せん妄や身体疾患の予後改善に関連する可能性が示されました。