Kong Jian, Lin Xu, Wang Bin, Xu Shanling, Wang Yuanlong, Hua Shuhui, Gong Hongyan, Dong Rui, Lin Yanan, Li Chuan, Bi Yanlin
Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China.
School of Anesthesiology, Shandong Second Medical University, Weifang, China.
Front Aging Neurosci. 2024 Apr 3;16:1353449. doi: 10.3389/fnagi.2024.1353449. eCollection 2024.
This study aims to explore the relationship between physical activity (PA) and postoperative delirium (POD).
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.
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).
Physical activity is probably a protective factor for POD and may exert a mediating effect through CSF biomarkers.
本研究旨在探讨体力活动（PA）与术后谵妄（POD）之间的关系。
我们从围手术期神经认知障碍与生物标志物生活方式（PNDABLE）数据库中选取了400例患者，该数据库中的患者进行了阿尔茨海默病生物标志物的采样和检测。使用意识模糊评估量表（CAM）进行POD的诊断，并使用纪念谵妄评估量表（MDAS）评估其严重程度。采用简易精神状态检查表（MMSE）量表检测患者的精神状态。采用酶联免疫吸附测定（ELISA）检测术前脑脊液（CSF）生物标志物水平，如淀粉样β蛋白42（Aβ42）、总tau蛋白（T-tau）和磷酸化tau蛋白（P-tau）。采用逻辑回归、敏感性分析和分析来探讨POD的风险因素与保护因素之间的关系。我们使用中介效应来探讨PA是否通过CSF生物标志物介导POD的发生。
POD的发生率为17.5%。根据我们的研究，结果提示PA可能是POD的保护因素[比值比（OR）：0.336，95%置信区间（95CI）0.206 - 0.548，<0.001]。逻辑回归结果显示，CSF生物标志物Aβ42（OR：0.997，95CI 0.996 - 0.999，<0.001）可能是预防POD的保护因素，而T-tau（OR：1.006，95CI 1.003 - 1.009，=0.001）和P-tau（OR：1.039，95CI 1.018 - 1.059，<0.001）可能是POD的风险因素。敏感性分析证实了POD患者中PA与CSF生物标志物之间的相关性。中介效应分析表明，PA可能部分通过CSF生物标志物如Aβ42（比例：11%，<0.05）、T-tau（比例：13%，<0.05）和P-tau（比例：12%，<0.05）降低POD的发生。
体力活动可能是POD的保护因素，并可能通过CSF生物标志物发挥中介作用。
