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Abstract：
UNASSIGNED: This study aims to explore the relationship between physical activity (PA) and postoperative delirium (POD).
UNASSIGNED: 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 post hoc 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.
UNASSIGNED: 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, P < 0.001]. The result of logistic regression revealed that CSF biomarker Aβ42 (OR: 0.997, 95 CI 0.996-0.999, P < 0.001) might be a protective factor against POD, and the T-tau (OR: 1.006, 95 CI 1.003-1.009, P = 0.001) and P-tau (OR: 1.039, 95 CI 1.018-1.059, P < 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%, P < 0.05), T-tau (proportion: 13%, P < 0.05), and P-tau (proportion: 12%, P < 0.05).
UNASSIGNED: Physical activity is probably a protective factor for POD and may exert a mediating effect through CSF biomarkers.
UNASSIGNED: 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 post hoc 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.
UNASSIGNED: 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, P < 0.001]. The result of logistic regression revealed that CSF biomarker Aβ42 (OR: 0.997, 95 CI 0.996-0.999, P < 0.001) might be a protective factor against POD, and the T-tau (OR: 1.006, 95 CI 1.003-1.009, P = 0.001) and P-tau (OR: 1.039, 95 CI 1.018-1.059, P < 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%, P < 0.05), T-tau (proportion: 13%, P < 0.05), and P-tau (proportion: 12%, P < 0.05).
UNASSIGNED: Physical activity is probably a protective factor for POD and may exert a mediating effect through CSF biomarkers.
摘要：
■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和生物标志物生活方式（PNDABLE）数据库中选择了400名患者，并对PNDABLE数据库中的患者进行了采样和检测。使用混淆评估量表（CAM）进行POD的诊断，并使用纪念谵妄评估量表（MDAS）评估严重程度。采用简易精神状态量表(MMSE)检测患者的精神状态。酶联免疫吸附试验(ELISA)检测术前脑脊液(CSF)生物标志物水平,如淀粉样β斑块42（Aβ42），总tau蛋白（T-tau），和磷酸化tau蛋白(P-tau)。Logistic回归，敏感性分析，并采用事后分析探讨POD风险与保护因素之间的关系。我们使用介导效应来探索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,P<0.001].Logistic回归分析结果显示,CSF生物标志物Aβ42(OR:0.997,95CI0.996-0.999,P<0.001)可能是POD的保护因素,T-tau（OR：1.006，95CI1.003-1.009，P=0.001）和P-tau（OR：1.039，95CI1.018-1.059，P<0.001）可能是POD的危险因素。敏感性分析证实了POD患者中PA和CSF生物标志物之间的相关性。中介效应分析显示,PA可能部分通过CSF生物标志物减少POD的发生,如Aβ42(比例：11%，P<0.05),T-tau（比例：13%，P<0.05),和P-tau(比例：12%，P<0.05)。
■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。
■我们从围手术期神经认知障碍和生物标志物生活方式（PNDABLE）数据库中选择了400名患者，并对PNDABLE数据库中的患者进行了采样和检测。使用混淆评估量表（CAM）进行POD的诊断，并使用纪念谵妄评估量表（MDAS）评估严重程度。采用简易精神状态量表(MMSE)检测患者的精神状态。酶联免疫吸附试验(ELISA)检测术前脑脊液(CSF)生物标志物水平,如淀粉样β斑块42（Aβ42），总tau蛋白（T-tau），和磷酸化tau蛋白(P-tau)。Logistic回归，敏感性分析，并采用事后分析探讨POD风险与保护因素之间的关系。我们使用介导效应来探索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,P<0.001].Logistic回归分析结果显示,CSF生物标志物Aβ42(OR:0.997,95CI0.996-0.999,P<0.001)可能是POD的保护因素,T-tau（OR：1.006，95CI1.003-1.009，P=0.001）和P-tau（OR：1.039，95CI1.018-1.059，P<0.001）可能是POD的危险因素。敏感性分析证实了POD患者中PA和CSF生物标志物之间的相关性。中介效应分析显示,PA可能部分通过CSF生物标志物减少POD的发生,如Aβ42(比例：11%，P<0.05),T-tau（比例：13%，P<0.05),和P-tau(比例：12%，P<0.05)。
■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。
