Physical Activity May a Probably Protective Factor for Postoperative Delirium: the PNDABLE Study

Overview

Journal Front Aging Neurosci

Specialty Geriatrics

Date 2024 Apr 18

PMID 38633981

Authors

Jian Kong

Xu Lin

Bin Wang

Shanling Xu

Yuanlong Wang

Shuhui Hua

Hongyan Gong

Rui Dong

Yanan Lin

Chuan Li

Yanlin Bi

Affiliations

Soon will be listed here.

Abstract

Objective: This study aims to explore the relationship between physical activity (PA) and postoperative delirium (POD).

Methods: We selected 400 patients from the Perioperative Neurocognitive Disorder and Biomarkers Lifestyle (PNDABLE) database, and the patients in the PNDABLE database were sampled and tested Alzheimer's biomarkers. The diagnosis of POD was made using the Confusion Assessment Scale (CAM) and the severity was assessed using Memorial Delirium Assessment Scale (MDAS). Mini-Mental State Examination (MMSE) scale was used to detect the mental state of the patients. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of preoperative cerebrospinal fluid (CSF) biomarkers, such as amyloid β plaque 42 (Aβ42), total tau protein (T-tau), and phosphorylated tau protein (P-tau). Logistic regression, sensitivity analysis, and analysis were used to explore the relationship between risk and protective factors on POD. We used the mediating effect to explore whether PA mediates the occurrence of POD through CSF biomarkers.

Results: The incidence of POD was 17.5%. According to our research, the consequence prompted that PA might be the protective factor for POD [odds ratio (OR): 0.336, 95% confidence interval (95 CI) 0.206-0.548, < 0.001]. The result of logistic regression revealed that CSF biomarker Aβ42 (OR: 0.997, 95 CI 0.996-0.999, < 0.001) might be a protective factor against POD, and the T-tau (OR: 1.006, 95 CI 1.003-1.009, = 0.001) and P-tau (OR: 1.039, 95 CI 1.018-1.059, < 0.001) might risk factors for POD. Sensitivity analysis confirmed the correlation between PA and CSF biomarkers in the patients with POD. Mediation effect analysis showed that PA may reduce the occurrence of POD partly through CSF biomarkers, such as Aβ42 (proportion: 11%, < 0.05), T-tau (proportion: 13%, < 0.05), and P-tau (proportion: 12%, < 0.05).

Conclusion: Physical activity is probably a protective factor for POD and may exert a mediating effect through CSF biomarkers.

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