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Plasma Neurofilament Light Chain is Markedly Elevated in General Hospital Inpatients with Delirium
Kang MJ, Eratne D, Borchard T, Patel K, Malpas CB, Dang C, Storer M, Bhalala OG et al.. medRxiv, 2026-10-20
Topic: Plasma and spinal-fluid biomarkers
Results In Phase 1 (n =176), inpatients with delirium showed higher concentrations of both NfL and GFAP than patients with dementia (β = 0.78; 95% CI [0.37, 1.20] and β = 0.39 [0.07, 0.73] respectively) or PPD groups (β = 1.17; [0.69, 1.66] and β = 0.83 [0.51, 1.24] respectively). In comparison, GFAP showed lower accuracy (AUC = 0.85), and combining NfL with GFAP (AUC = 0.90) did not significantly improve performance. What this study adds Plasma neurofilament light chain (NfL) is substantially elevated in general hospital inpatients with delirium compared to those with dementia or primary psychiatric disorders. How this study might affect research, practice or policy These findings support the prospective evaluation of plasma NfL as an objective adjunct to clinical bedside assessments. This biomarker could significantly aid in evaluating patients with acute confusion, particularly when hypoactive presentations make clinical diagnosis challenging.
Key findings
- Results In Phase 1 (n =176), inpatients with delirium showed higher concentrations of both NfL and GFAP than patients with dementia (β = 0.78; 95% CI [0.37, 1.20] and β = 0.39 [0.07, 0.73] respectively) or PPD groups (β = 1.17; [0.69, 1.66] and β = 0.83 [0.51, 1.24] respectively).
- In comparison, GFAP showed lower accuracy (AUC = 0.85), and combining NfL with GFAP (AUC = 0.90) did not significantly improve performance.
- What this study adds Plasma neurofilament light chain (NfL) is substantially elevated in general hospital inpatients with delirium compared to those with dementia or primary psychiatric disorders.
- How this study might affect research, practice or policy These findings support the prospective evaluation of plasma NfL as an objective adjunct to clinical bedside assessments.
- This biomarker could significantly aid in evaluating patients with acute confusion, particularly when hypoactive presentations make clinical diagnosis challenging.
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Study details
- Study designcross-sectional
- Participants176
- Effect sizeAUC = 0.89; AUC = 0.85; AUC = 0.90
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 44 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 62 points we could judge it on, which is 44 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 176 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 27 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 27 of the 62 points we could judge it on is 44 out of 100. |
| Total | 44 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Kang, M. J., Eratne, D., Borchard, T., Patel, K., Malpas, C. B., Dang, C., et al. (2026). Plasma Neurofilament Light Chain is Markedly Elevated in General Hospital Inpatients with Delirium. medRxiv. https://doi.org/10.64898/2026.10.18.26365854
Vancouver
Kang MJ, Eratne D, Borchard T, Patel K, Malpas CB, Dang C, et al. Plasma Neurofilament Light Chain is Markedly Elevated in General Hospital Inpatients with Delirium. medRxiv. 2026. doi:10.64898/2026.10.18.26365854.
BibTeX
@article{kang2026-25f2d41d,
author = {Kang, M. J. and Eratne, D. and Borchard, T. and Patel, K. and Malpas, C. B. and Dang, C. and Storer, M. and Bhalala, O. G. and others},
title = {{Plasma Neurofilament Light Chain is Markedly Elevated in General Hospital Inpatients with Delirium}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.10.18.26365854},
url = {https://doi.org/10.64898/2026.10.18.26365854}
}
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