The study was led by Professor Ailin Luo from Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology and was funded by National Key R&D Program of China (Program No. 2020YFC2009002).
The study enrolled 2,257 patients aged 75 and older who underwent elective noncardiac and noncranial surgeries at 16 Chinese medical centers between September 2021 and November 2023. Preoperative cognitive function was assessed using the Mini-Cog test, a brief tool that combines memory and clock-drawing tasks (scores ≤2 indicate cognitive impairment). Postoperative delirium was diagnosed using the Confusion Assessment Method (CAM) or CAM-ICU for intubated patients.
Key findings from the cohort study include:
To investigate potential causality, researchers performed a two-sample MR analysis using 139 genetic variants (single nucleotide polymorphisms, SNPs) associated with cognitive performance from European ancestry datasets. The inverse-variance weighted method showed higher cognitive performance was associated with a 26% reduced delirium risk (OR 0.74, 95% CI 0.59–0.93, p=0.009), with no significant pleiotropy or heterogeneity.
“Our findings suggest preoperative cognitive screening with the Mini-Cog—simple and quick to administer—could become a valuable tool in preoperative risk assessment,” said Ailin Luo, corresponding author. “Identifying high-risk patients early may allow for targeted interventions, such as optimized anesthesia regimens or postoperative sleep support, to reduce POD incidence.”
The study notes limitations, including potential selection bias (excluding emergency surgeries and severe cognitive impairment cases) and the use of European genetic data, which may limit generalizability to Asian populations. Further research with diverse genetic datasets is needed to confirm the causal link.
See the article:
Association Between Preoperative Cognitive Performance and Postoperative Delirium in Older Patients: Results From a Multicenter, Prospective Cohort Study, and a Mendelian Randomization Study
https://doi.org/10.1002/mco2.70302
MedComm
17-Jul-2025