Investigating the Ageing Immune System in Hospitalised Older People

• Research type

  Research Study

• Full title

  Investigating the Ageing Immune System in Hospitalised Older People

• IRAS ID

  252253

• Contact name

  Thomas Jackson

• Contact email

  t.jackson@bham.ac.uk

• Sponsor organisation

  University of Birmingham

• Clinicaltrials.gov Identifier

  NA, NA

• Duration of Study in the UK

  1 years, 7 months, 1 days

• Research summary

  Delirium is common in older people admitted to hospital and is associated with poor outcomes. The pathophysiology of delirium is not well understood but inflammation has been proposed as a mechanism. Changes to the immune system occur with age, called immunosenescence, and we think these may explain why older people are more likely to get delirium.
  Aims:
  1) To characterise the composition of immune cells in older hospitalised people with and without delirium.
  2) To assess the function of immune cells in older hospitalised people with and without delirium.
  3) To measure inflammatory markers in older hospitalised people with and without delirium.
  4) To clinically characterise the population of older people who have delirium on admission to hospital.
  Method:
  People aged over 70 who are admitted to hospital as an emergency will be screened for delirium. Where delirium is present this will be confirmed using the gold standard Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM V) criteria. Delirium screening is part of standard care in older people admitted to hospital. We will recruit 75 participants with delirium and 75 participants without delirium. Key clinical variables will be collected for the two groups. A one off blood sample will be collected from the two groups. This will be used for a number of pilot experiments investigating the composition and function of immune cells and inflammatory markers, in patients with and without delirium. Each pilot experiment will require 15 participants in each arm.
  Inclusion criteria:
  1) Aged over 70
  2) Anticipated stay in hospital >24 hours
  3) Admitted to the acute medical assessment unit at Queen Elizabeth Hospital Birmingham
  Exclusion criteria:
  1) Patients likely to die in the next 24 hours
  2) Inability to communicate due to severe sensory impairment
  3) Inability to communicate due to non-competence in the English language
  4) Immunomodulatory medications
  5) Haematological malignancy
  Outcomes:
  Primary outcome:
  Diagnosis of delirium by DSM V criteria
  Secondary outcomes:
  Delirium motor subtype
  Length of stay
  Mortality
  Discharge destination

• REC name

  Wales REC 4

• REC reference

  19/WA/0136

• Date of REC Opinion

  15 May 2019

• REC opinion

  Further Information Favourable Opinion