The goal of this observational study is to learn how exercise-induced irisin protects the brain. It also explores irisin's effect on postoperative delirium (POD) in older adults. The main questions it aims to answer are:
Does daily activity link to POD? Does irisin play a mediating role in this process? Researchers will enroll active and inactive adults aged 65 and older. All will have surgery under spinal anesthesia. The researchers will measure irisin levels in spinal fluid. They will track POD and other complications for five days after surgery.
Aged ≥ 65 years;
Classified as ASA physical status I to III;
Scheduled for non-cardiovascular surgery under spinal anesthesia or combined spinal-epidural anesthesia;
Expected surgical duration of at least 2 hours;
Significant change in exercise status within the past 7 days due to injury or other reasons;
Contraindications to neuraxial anesthesia;
Unable to assess cognitive function or Montreal Cognitive Assessment (MoCA) score < 23;
Preoperative diagnosis of delirium;
Patients scheduled for elective surgery at Peking University People's Hospital.
Cohort
Prospective
Preoperative physical activity level
BehavioralBefore the surgery, the activity levels of the participants over the past week were assessed using the Physical Activity Scale for the Elderly (PASE).
Postoperative Delirium
Delirium will be assessed using the CAM or CAM-ICU (for patients in the ICU) by researchers twice daily. For patients who develop POD, the severity of POD will be evaluated using the Delirium Rating Scale-Revised-98 (DRS-R-98).
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