Physical activity may a probably protective factor for postoperative delirium: the PNDABLE study.

Area of Science:

• Neuroscience
• Gerontology
• Clinical Medicine

Background:

• Postoperative delirium (POD) is a common complication in elderly patients.
• Understanding risk and protective factors for POD is crucial for improving patient outcomes.
• The role of physical activity (PA) and its relationship with Alzheimer's biomarkers in POD remains an area of active investigation.

Purpose of the Study:

• To investigate the association between physical activity (PA) and the occurrence of postoperative delirium (POD).
• To explore the potential mediating role of cerebrospinal fluid (CSF) Alzheimer's biomarkers in the relationship between PA and POD.

Main Methods:

• Analysis of 400 patients from the Perioperative Neurocognitive Disorder and Biomarkers Lifestyle (PNDABLE) database.
• Assessment of POD using the Confusion Assessment Scale (CAM) and Memorial Delirium Assessment Scale (MDAS).
• Measurement of CSF biomarkers (Aβ42, T-tau, P-tau) using ELISA and statistical analysis including logistic regression and mediation effects.

Main Results:

• Physical activity (PA) was identified as a significant protective factor against postoperative delirium (POD) (OR: 0.336, P < 0.001).
• CSF biomarker Aβ42 showed a protective effect (OR: 0.997, P < 0.001), while T-tau (OR: 1.006, P = 0.001) and P-tau (OR: 1.039, P < 0.001) were associated with increased POD risk.
• Mediation analysis indicated that PA may reduce POD occurrence partly through its influence on CSF biomarkers (Aβ42: 11%, T-tau: 13%, P-tau: 12% mediation).

Conclusions:

• Physical activity (PA) is a potential protective factor for postoperative delirium (POD).
• CSF biomarkers, including Aβ42, T-tau, and P-tau, may mediate the effect of PA on POD.
• These findings suggest that promoting physical activity could be a strategy to mitigate POD risk.