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The complex interaction of genetics and delirium: a systematic review and meta-analysis

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Abstract

The objective is to understand genetic predisposition to delirium. Following PRISMA guidelines, we undertook a systematic review of studies involving delirium and genetics in the databases of Pubmed, Scopus, Cochrane Library and PsycINFO, and performed a meta-analysis when appropriate. We evaluated 111 articles, of which 25 were finally included in the analysis. The studies were assessed by two independent researchers for methodological quality using the Downs and Black Tool and for genetic analysis quality. We performed a meta-analysis of 10 studies of the Apolipoprotein E (APOE) gene, obtaining no association with the presence of delirium (LOR 0.18, 95% CI − 0.10–0.47, p = 0.21). Notably, only 5 out of 25 articles met established criteria for genetic studies (good quality) and 6 were of moderate quality. Seven studies found an association with APOE4, the dopamine transporter gene SCL6A3, dopamine receptor 2 gene, glucocorticoid receptor, melatonin receptor and mitochondrial DNA haplotypes. One genome-wide association study found two suggestive long intergenic non-coding RNA genes. Five studies found no association with catechol-o-methyltransferase, melatonin receptor or several interleukins genes. The studies were heterogenous in establishing the presence of delirium. Future studies with large samples should further specify the delirium phenotype and deepen our understanding of interactions between genes and other biological factors.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Psiquiàtric Universitari Institut Pere Mata, IISPV, C/Institut Pere Mata, S/N, 43206, Reus, Spain

    Esteban Sepulveda, Selena Aranda & Elisabet Vilella

  2. Universitat Rovira i Virgili, Tarragona, Spain

    Esteban Sepulveda, Selena Aranda & Elisabet Vilella

  3. Sligo Mental Health Services, Clarion Rd, Sligo, Ireland

    Dimitrios Adamis

  4. Grupo de Investigación en Psiquiatría de Enlace, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia

    Jose G. Franco

  5. School of Medicine, University of Limerick, Limerick, Ireland

    David Meagher

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  1. Esteban Sepulveda
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  2. Dimitrios Adamis
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  3. Jose G. Franco
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  4. David Meagher
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  5. Selena Aranda
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  6. Elisabet Vilella
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Contributions

ES and EV developed the article’s concept; ES and DA performed the article search; ES, DA and DM performed the methodological quality analysis; EV and SA performed the genetic quality analysis; DA performed the meta-analysis; ES and DA wrote a first draft of the manuscript; all the authors critically revised the work and all the authors read and approved the final manuscript.

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Correspondence to Esteban Sepulveda.

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Sepulveda, E., Adamis, D., Franco, J.G. et al. The complex interaction of genetics and delirium: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 271, 929–939 (2021). https://doi.org/10.1007/s00406-021-01255-x

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  • DOI: https://doi.org/10.1007/s00406-021-01255-x

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