Editing Delirium (section)

===Neuropathology===
Only a handful of studies exist where there has been an attempt to correlate delirium with pathological findings at autopsy. One research study has been reported on 7 people who died during ICU admission.<ref>{{cite journal | vauthors = Janz DR, Abel TW, Jackson JC, Gunther ML, Heckers S, Ely EW | title = Brain autopsy findings in intensive care unit patients previously suffering from delirium: a pilot study | journal = Journal of Critical Care | volume = 25 | issue = 3 | pages = 538.e7–538.12 | date = September 2010 | pmid = 20580199 | pmc = 3755870 | doi = 10.1016/j.jcrc.2010.05.004 }}</ref> Each case was admitted with a range of primary pathologies, but all had [[acute respiratory distress syndrome]] and/or [[septic shock]] contributing to the delirium, 6 showed evidence of low brain perfusion and diffuse vascular injury, and 5 showed [[Hippocampus|hippocampal]] involvement. A case-control study showed that 9 delirium cases showed higher expression of [[HLA-DR]] and [[CD68]] (markers of microglial activation), IL-6 (cytokines pro-inflammatory and anti-inflammatory activities) and GFAP (marker of [[astrocyte]] activity) than age-matched controls; this supports a neuroinflammatory cause to delirium, but the conclusions are limited by methodological issues.<ref>{{cite journal | vauthors = Munster BC, Aronica E, Zwinderman AH, Eikelenboom P, Cunningham C, Rooij SE | title = Neuroinflammation in delirium: a postmortem case-control study | journal = Rejuvenation Research | volume = 14 | issue = 6 | pages = 615–622 | date = December 2011 | pmid = 21978081 | pmc = 4309948 | doi = 10.1089/rej.2011.1185 }}</ref>

A 2017 retrospective study correlating autopsy data with [[mini–mental state examination]] (MMSE) scores from 987 brain donors found that delirium combined with a pathological process of dementia accelerated MMSE score decline more than either individual process.<ref>{{cite journal | vauthors = Davis DH, Muniz-Terrera G, Keage HA, Stephan BC, Fleming J, Ince PG, Matthews FE, Cunningham C, Ely EW, MacLullich AM, Brayne C | title = Association of Delirium With Cognitive Decline in Late Life: A Neuropathologic Study of 3 Population-Based Cohort Studies | journal = JAMA Psychiatry | volume = 74 | issue = 3 | pages = 244–251 | date = March 2017 | pmid = 28114436 | pmc = 6037291 | doi = 10.1001/jamapsychiatry.2016.3423 }}</ref>