Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study
ABSTRACT This study evaluated the association between preoperative cognitive performance and postoperative delirium (POD) using a multicenter prospective cohort, and explored potential causality using Mendelian randomization (MR) analysis. We analyzed data from 2257 patients aged ≥ 75 years undergoi...
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2025-08-01
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| Online Access: | https://doi.org/10.1002/mco2.70302 |
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| author | Rao Sun Shiyong Li Changming Yang Guiming Huang Chunrong Tang Wei Li Zhongyuan Xia Mingzhang Zuo Ning Yang Huiyu Luo Kun Zhang Huajun Li Qingfeng Zeng Chun Chen Lan Wang Rui Xia Chuanbin Dong Junmin He Qiaoqiao Xu Xinhua Li Biyun Zhou Shangkun Liu Fang Luo Zhiqiang Zhou Ailin Luo |
| author_facet | Rao Sun Shiyong Li Changming Yang Guiming Huang Chunrong Tang Wei Li Zhongyuan Xia Mingzhang Zuo Ning Yang Huiyu Luo Kun Zhang Huajun Li Qingfeng Zeng Chun Chen Lan Wang Rui Xia Chuanbin Dong Junmin He Qiaoqiao Xu Xinhua Li Biyun Zhou Shangkun Liu Fang Luo Zhiqiang Zhou Ailin Luo |
| author_sort | Rao Sun |
| collection | DOAJ |
| description | ABSTRACT This study evaluated the association between preoperative cognitive performance and postoperative delirium (POD) using a multicenter prospective cohort, and explored potential causality using Mendelian randomization (MR) analysis. We analyzed data from 2257 patients aged ≥ 75 years undergoing elective noncardiac and noncranial surgeries across 16 Chinese medical centers. Preoperative cognitive assessment using Mini‐Cog revealed 28.4% of patients had cognitive impairment (score ≤ 2). POD occurred in 9.7% of patients, with higher incidence among those with cognitive impairment. Logistic regression demonstrated that cognitive impairment was significantly associated with increased POD risk (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.55–2.74; p < 0.001). This association persisted after adjustment for demographic, preoperative, and intraoperative factors, and was confirmed through propensity score matching and inverse probability treatment weighting analyses. A nearly linear inverse association was observed between Mini‐Cog scores and POD incidence. Complementary MR analysis using 139 SNPs from European ancestry data suggested that higher cognitive performance might be associated with decreased delirium risk (inverse‐variance weighted OR, 0.74; 95% CI, 0.59–0.93; p = 0.009). Although these results point to a potential link between preoperative cognition and POD, interpretation of causality should be approached with caution, particularly given differences in populations and genetic datasets. |
| format | Article |
| id | doaj-art-0a270c8bbf934d30aa15a1b13b8c4df3 |
| institution | Kabale University |
| issn | 2688-2663 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | MedComm |
| spelling | doaj-art-0a270c8bbf934d30aa15a1b13b8c4df32025-08-20T04:02:50ZengWileyMedComm2688-26632025-08-0168n/an/a10.1002/mco2.70302Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization StudyRao Sun0Shiyong Li1Changming Yang2Guiming Huang3Chunrong Tang4Wei Li5Zhongyuan Xia6Mingzhang Zuo7Ning Yang8Huiyu Luo9Kun Zhang10Huajun Li11Qingfeng Zeng12Chun Chen13Lan Wang14Rui Xia15Chuanbin Dong16Junmin He17Qiaoqiao Xu18Xinhua Li19Biyun Zhou20Shangkun Liu21Fang Luo22Zhiqiang Zhou23Ailin Luo24Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology Jingmen Central Hospital Jingmen ChinaDepartment of Anesthesiology Ganzhou People's Hospital Ganzhou ChinaDepartment of Anesthesiology Songzi People's Hospital Jingzhou ChinaDepartment of Anesthesiology Gong'an County People's Hospital Jingzhou ChinaDepartment of Anesthesiology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Anesthesiology Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing ChinaDepartment of Anesthesiology Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing ChinaDepartment of Anesthesiology No.1 People's Hospital Hubei University of Medicine Xiangyang ChinaDepartment of Anesthesiology Jingzhou Hospital Affiliated to Yangtze University Jingzhou ChinaDepartment of Anesthesiology Jianshi County People's Hospital Enshi ChinaDepartment of Anesthesiology Gong'an County Traditional Chinese Medicine Hospital Jingzhou ChinaDepartment of Anesthesiology Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University Yichang ChinaDepartment of Anesthesiology Jingzhou Third People's Hospital Jingzhou ChinaDepartment of Anesthesiology The First Affiliated Hospital of Yangtze University Jingzhou ChinaDepartment of Anesthesiology Zhijiang People's Hospital Yichang ChinaDepartment of Anesthesiology Jingmen People's Hospital Jingmen ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaABSTRACT This study evaluated the association between preoperative cognitive performance and postoperative delirium (POD) using a multicenter prospective cohort, and explored potential causality using Mendelian randomization (MR) analysis. We analyzed data from 2257 patients aged ≥ 75 years undergoing elective noncardiac and noncranial surgeries across 16 Chinese medical centers. Preoperative cognitive assessment using Mini‐Cog revealed 28.4% of patients had cognitive impairment (score ≤ 2). POD occurred in 9.7% of patients, with higher incidence among those with cognitive impairment. Logistic regression demonstrated that cognitive impairment was significantly associated with increased POD risk (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.55–2.74; p < 0.001). This association persisted after adjustment for demographic, preoperative, and intraoperative factors, and was confirmed through propensity score matching and inverse probability treatment weighting analyses. A nearly linear inverse association was observed between Mini‐Cog scores and POD incidence. Complementary MR analysis using 139 SNPs from European ancestry data suggested that higher cognitive performance might be associated with decreased delirium risk (inverse‐variance weighted OR, 0.74; 95% CI, 0.59–0.93; p = 0.009). Although these results point to a potential link between preoperative cognition and POD, interpretation of causality should be approached with caution, particularly given differences in populations and genetic datasets.https://doi.org/10.1002/mco2.70302cognitive impairmentMendelian randomizationMini‐Cog testpostoperative deliriumprospective cohort study |
| spellingShingle | Rao Sun Shiyong Li Changming Yang Guiming Huang Chunrong Tang Wei Li Zhongyuan Xia Mingzhang Zuo Ning Yang Huiyu Luo Kun Zhang Huajun Li Qingfeng Zeng Chun Chen Lan Wang Rui Xia Chuanbin Dong Junmin He Qiaoqiao Xu Xinhua Li Biyun Zhou Shangkun Liu Fang Luo Zhiqiang Zhou Ailin Luo Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study MedComm cognitive impairment Mendelian randomization Mini‐Cog test postoperative delirium prospective cohort study |
| title | Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study |
| title_full | Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study |
| title_fullStr | Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study |
| title_full_unstemmed | Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study |
| title_short | Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study |
| title_sort | association between preoperative cognitive performance and postoperative delirium in older patients results from a multicenter prospective cohort study and a mendelian randomization study |
| topic | cognitive impairment Mendelian randomization Mini‐Cog test postoperative delirium prospective cohort study |
| url | https://doi.org/10.1002/mco2.70302 |
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