Study on the causal relationship between educational attainment and delirium: A two-sample Mendelian randomization...

Area of Science:

• Genetics
• Epidemiology
• Neuroscience

Background:

• Delirium is a common clinical condition with significant morbidity.
• The relationship between educational attainment and delirium is complex.
• Understanding genetic factors may elucidate causal pathways.

Purpose of the Study:

• To investigate the causal relationship between educational attainment and delirium at the genetic level.
• To provide novel genetic evidence on the association between education and delirium.
• To explore whether genetic predisposition to higher education reduces delirium risk.

Main Methods:

• Mendelian randomization analysis utilizing single nucleotide polymorphisms (SNPs) as instrumental variables.
• Inverse variance weighting (IVW) as the primary analysis method.
• Supplementary analyses including weighted median, Mendelian Randomization-Egger, and mode-based methods.
• Tests for horizontal pleiotropy and heterogeneity (e.g., MR-Egger intercept, MR-PRESSO, Cochran's Q).
• Multivariate Mendelian randomization to adjust for confounders.

Main Results:

• A significant causal effect of genetically predicted educational attainment on delirium was found (IVW: OR=0.67, 95% CI [0.49-0.92], p=0.013).
• Results were consistent across various sensitivity analyses, including MR-PRESSO and multivariate MR.
• No evidence of significant pleiotropy or heterogeneity was detected.
• Leave-one-out analysis confirmed the robustness of the findings.

Conclusions:

• There is a genetic causal relationship between higher educational attainment and a lower risk of delirium.
• Higher educational attainment appears to be a protective factor against delirium.
• Clinical attention should be directed towards individuals with low educational attainment who are at high risk for delirium.