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Systemic inflammation, delirium and clinical progression in mild-moderate Alzheimer disease
Adam H. Dyer, Helena Dolphin, Laura J. Morrison, Tara Kenny, Padraic G. Fallon, Colm M. Cunningham, Antoinette O'Connor, BRIAN A. LAWLOR et al.. EBioMedicine, 2026-02-17
Topic: Amyloid, tau and blood-test diagnosis
Systemic inflammatory biomarkers were primarily associated with age/socio-demographic characteristics, remained strikingly stable over time, and were not associated with AD progression. Rather, higher baseline plasma p-tau217 was associated with greater yearly progression on both the ADAS-Cog (β: 2.82; 95% CI: 1.12, 4.52; nominal p = 0.001) and DAD (β: -2.34; 95% CI: -3.86, -0.82; nominal p = 0.003). Higher baseline GFAP was also associated with subsequent decline on both the CDR-Sb (β: 1.02; 95% CI: 0.38, 1.67; nominal p = 0.002) and DAD (β: 1.91; 95% CI: -3.45, -0.37; nominal p = 0.02). Experiencing one or more episodes of delirium was associated with accelerated decline on the CDR-Sb at 18-months (β: 2.63; 95% CI: 1.55, 3.71; adjusted p < 0.001). Biomarkers of neuroinflammation (GFAP), neurodegeneration (p-tau217) and incident delirium, rather than systemic inflammatory biomarkers, were associated with clinically-significant decline in mild-moderate AD. FUNDING: European Commission (FP7 grant; 279093); Meath Foundation (MFRG 121/2021); Wellcome Trust (227946/Z/23/Z & 203930/B/16/Z); Health Research Board (203930/B/16/Z; ECSA-2024-003).
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APA 7th
Dyer, A. H., Dolphin, H., Morrison, L. J., Kenny, T., Fallon, P. G., Cunningham, C. M., et al. (2026). Systemic inflammation, delirium and clinical progression in mild-moderate Alzheimer disease. EBioMedicine. https://doi.org/10.1016/j.ebiom.2026.106159
Vancouver
Dyer AH, Dolphin H, Morrison LJ, Kenny T, Fallon PG, Cunningham CM, et al. Systemic inflammation, delirium and clinical progression in mild-moderate Alzheimer disease. EBioMedicine. 2026. doi:10.1016/j.ebiom.2026.106159. PMID: 41708398.
BibTeX
@article{dyer2026-41708398,
author = {Dyer, Adam H. and Dolphin, Helena and Morrison, Laura J. and Kenny, Tara and Fallon, Padraic G. and Cunningham, Colm M. and O'Connor, Antoinette and LAWLOR, BRIAN A. and others},
title = {{Systemic inflammation, delirium and clinical progression in mild-moderate Alzheimer disease}},
journal = {EBioMedicine},
year = {2026},
doi = {10.1016/j.ebiom.2026.106159},
pmid = {41708398},
url = {https://doi.org/10.1016/j.ebiom.2026.106159}
}
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.
Key findings
- Systemic inflammatory biomarkers were primarily associated with age/socio-demographic characteristics, remained strikingly stable over time, and were not associated with AD progression.
- Rather, higher baseline plasma p-tau217 was associated with greater yearly progression on both the ADAS-Cog (β: 2.82; 95% CI: 1.12, 4.52; nominal p = 0.001) and DAD (β: -2.34; 95% CI: -3.86, -0.82; nominal p = 0.003).
- Higher baseline GFAP was also associated with subsequent decline on both the CDR-Sb (β: 1.02; 95% CI: 0.38, 1.67; nominal p = 0.002) and DAD (β: 1.91; 95% CI: -3.45, -0.37; nominal p = 0.02).
- Experiencing one or more episodes of delirium was associated with accelerated decline on the CDR-Sb at 18-months (β: 2.63; 95% CI: 1.55, 3.71; adjusted p < 0.001).
- Biomarkers of neuroinflammation (GFAP), neurodegeneration (p-tau217) and incident delirium, rather than systemic inflammatory biomarkers, were associated with clinically-significant decline in mild-moderate AD.
Why it matters
Systemic inflammatory biomarkers were not associated with Alzheimer's progression, but higher baseline plasma p-tau217 and GFAP, and experiencing delirium, were linked to faster decline. This points to these markers and delirium as things to watch, not to any treatment that changes the disease course.
New to this subject? Start with our plain-English guide: Blood tests & biomarkers →
Study details
- Participants333
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (EBioMedicine) |
| Journal's citation record | 2 / 4 | EBioMedicine: journal h-index 181 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 333 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 4 / 6 | Cited 9.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Seán Kennelly: h-index 35 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Trinity College Dublin: institution h-index 926 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41708398) |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
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