BackgroundDelirium is an important risk factor for subsequent dementia. However, the field lacks large studies with long-term follow-up of delirium in subjects initially free of dementia to clearly establish clinical trajectories.MethodsWe undertook a retrospective cohort study of all patients over the age of 65 diagnosed with an episode of delirium who were initially dementia free at onset of delirium within National Health Service Greater Glasgow & Clyde between 1996 and 2020 using the Safe Haven database. We estimated the cumulative incidence of dementia accounting for the competing risk of death without a dementia diagnosis. We modelled the effects of age at delirium diagnosis, sex and socioeconomic deprivation on the cause-specific hazard of dementia via cox regression.Results12 949 patients with an incident episode of delirium were included and followed up for an average of 741 days. The estimated cumulative incidence of dementia was 31% by 5 years. The estimated cumulative incidence of the competing risk of death without dementia was 49.2% by 5 years. The cause-specific hazard of dementia was increased with higher levels of deprivation and also with advancing age from 65, plateauing and decreasing from age 90. There did not appear to be a relationship with sex.ConclusionsOur study reinforces the link between delirium and future dementia in a large cohort of patients. It highlights the importance of early recognition of delirium and prevention where possible.

Exploration of neuroimmune mechanisms is vital to the understanding of the pathogenesis and pathophysiology of mental disorders. Inflammatory and immune mechanisms are increasingly understood to underpin a number of neuropsychiatric disorders, with an ever-expanding evidence base drawn from basic science to large-scale epidemiological data. Unravelling of these mechanisms should lead to biomarker discovery and potential new avenues for therapeutics that modulate immunological mechanisms. Identification of neuroimmune biomarkers is vital to improving diagnosis, stratification and treatment of mental disorders. There is an urgent clinical need for new therapeutic approaches with poor treatment response and treatment resistance a major problem for many psychiatric disorders including depression and schizophrenia. Neurodegenerative psychiatric disorders such as Alzheimer's also have clear neuroimmune underpinnings and manifest an urgent clinical need for improvements in diagnosis and research towards transformative disease-modifying treatments. This chapter provides some background on the role of the neuroimmune system in mental illness, exploring the role for biomarkers, in addition to reviewing the current state of knowledge in this exciting field. We also reflect on the inherent challenges and methodological pitfalls faced by research in this field, including the complexity of conceptualising multidimensional mental disorders and the dynamic shifting sands of the immune system.

Spring cabbage plants (Brassica oleracea L. Capitata group) grown by no-tillage culture yielded less than conventionally tilled plants when grown under the same N treatment and spacing. No-till yields could be compensated somewhat by increasing plant population and N, but head size was generally smaller than for conventionally tilled plants. Large head size was positively correlated with high N content of wrapper leaves in 3 of 4 years, while high Ca was associated with large plants or heads in 2 of 4 years.

Depression in old age is common and associated with significant morbidity, yet it is frequently missed or undertreated. In this article, the authors review the specific issues that need to be taken into account when assessing and treating depression in elderly people.

Trumpetcreeper [Campsis radicans(L.) Seem.] grown from 10-cm root sections was more susceptible to foliar applications of 2,4-D [(2,4-dichlorophenoxy)acetic acid] and dicamba (3,6-dichloro-o-anisic acid) than trumpetcreeper grown from 45-cm root sections. Dicamba controlled trumpetcreeper better than did 2,4-D, particularly trumpetcreeper grown from 45-cm root sections. More14C-dicamba than14C-2,4-D was absorbed through the foliage and translocated to the roots of trumpetcreeper grown from 10-cm roots. No14C-2,4-D was detected in the 45-cm roots; however,14C-dicamba was recovered from both the upper and the lower sections of the 45-cm roots.