Open Access
Biomarkers of delirium risk in older adults: a systematic review and meta-analysis
(Frontiers Media, 2023) Lozano Vicario, Lucía; García Hermoso, Antonio; Cedeño Veloz, Bernardo Abel; Fernández Irigoyen, Joaquín; Santamaría Martínez, Enrique; Romero Ortuno, Román; Zambom Ferraresi, Fabrício; López Sáez de Asteasu, Mikel; Muñoz-Vázquez, Ángel Javier; Izquierdo Redín, Mikel; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Delirium is a neuropsychiatric syndrome associated with increased morbidity and mortality in older patients. The aim of this study was to review predictive biomarkers of delirium in older patients to gain insights into the pathophysiology of this syndrome and provide guidance for future studies. Two authors independently and systematically searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases up to August 2021. A total of 32 studies were included. Only 6 studies were eligible for the meta-analysis, pooled results showed a significant increase in some serum biomarkers (C-reactive protein [CRP], tumour necrosis factor alpha [TNF-α] and interleukin-6 [IL-6]) among patients with delirium (odds ratio = 1.88, 95% CI 1.01 to 1.637; I2 = 76.75%). Although current evidence does not favour the use of any particular biomarker, serum CRP, TNF-α, and IL-6 were the most consistent biomarkers of delirium in older patients.
Open Access
Effectiveness of a multicomponent exercise training program for the management of delirium in hospitalized older adults using near-infrared spectroscopy as a biomarker of brain perfusion: study protocol for a randomized controlled trial
(Frontiers Media, 2022) Lozano Vicario, Lucía; Zambom Ferraresi, Fabíola; Zambom Ferraresi, Fabrício; Casa Marín, Antón de la; Ollo Martínez, Iranzu; López Sáez de Asteasu, Mikel; Cedeño Veloz, Bernardo Abel; Fernández Irigoyen, Joaquín; Santamaría Martínez, Enrique; Romero Ortuno, Román; Izquierdo Redín, Mikel; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Delirium is an important cause of morbidity and mortality in older adults admitted to hospital. Multicomponent interventions targeting delirium risk factors, including physical exercise and mobilization, have been shown to reduce delirium incidence by 30–40% in acute care settings. However, little is known about its role in the evolution of delirium, once established. This study is a randomized clinical trial conducted in the Acute Geriatric Unit of Hospital Universitario de Navarra (Pamplona, Spain). Hospitalized patients with delirium who meet the inclusion criteria will be randomly assigned to the intervention or the control group. The intervention will consist of a multicomponent exercise training program, which will be composed of supervised progressive resistance and strength exercise over 3 consecutive days. Functional Near-Infrared Spectroscopy (NIRS) will be used for assessing cerebral and muscle tissue blood flow. The objective is to assess the effectiveness of this intervention in modifying the following primary outcomes: duration and severity of delirium and functional status. This study will contribute to determine the effectiveness of physical exercise in the management of delirium. It will be the first study to evaluate the impact of a multicomponent intervention based on physical exercise in the evolution of delirium.
Open Access
Delirium en el adulto mayor: de los biomarcadores a la práctica clínica
(2024) Lozano Vicario, Lucía; Martínez Velilla, Nicolás; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
La presente tesis doctoral gira en torno al potencial uso de los biomarcadores para predecir delirium en los adultos mayores y el uso de ejercicio físico como herramienta para modificar la evolución de éste una vez instaurado. El delirium es un síndrome neuropsiquiátrico grave y muy frecuente en los ancianos que conduce a la discapacidad y el deterioro cognitivo, entre otros. Los biomarcadores pueden ser una estrategia mínimamente invasiva y eficaz para predecir el delirium, ayudando a conocer mejor su fisiopatología y pudiendo contribuir al desarrollo de futuras dianas terapéuticas. Esta tesis doctoral se basa en 3 estudios publicados en disentas revistas nacionales e internacionales. En el primer estudio (capítulo 1) nuestro objetivo fue evaluar la evidencia existente sobre los biomarcadores predictivos de delirium en el adulto mayor. En el segundo estudio (capítulos 2 y 3) el objetivo principal fue analizar la asociación entre distintos biomarcadores en sangre y líquido cefalorraquídeo de pacientes con fractura de cadera y la incidencia de delirium. En el tercer estudio (capítulos 4 y 5) el objetivo principal fue determinar la utilidad de un programa de ejercicio multicomponente en la evolución de pacientes mayores hospitalizados con delirium utilizando el NIRS como biomarcador de perfusión cerebral.
Open Access
The impact of geriatric conditions in elderly patients with coronary heart disease: a state-of-the-art review
(MDPI, 2024) Alonso Salinas, Gonzalo Luis; Cepas-Guillén, Pedro; Martínez León, Amaia; Jiménez-Méndez, César; Lozano Vicario, Lucía; Martínez-Avial, María; Díez-Villanueva, Pablo; Ciencias de la Salud; Osasun Zientziak
The growing geriatric population presenting with coronary artery disease poses a primary challenge for healthcare services. This is a highly heterogeneous population, often underrepresented in studies and clinical trials, with distinctive characteristics that render them particularly vulnerable to standard management/approaches. In this review, we aim to summarize the available evidence on the treatment of acute coronary syndrome in the elderly. Additionally, we contextualize frailty, comorbidity, sarcopenia, and cognitive impairment, common in these patients, within the realm of coronary artery disease, proposing strategies for each case that may assist in therapeutic approaches.

Lozano Vicario, Lucía

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