Imagine your brain as a bustling city, with social networks as the intricate roads connecting different neighborhoods. In a recent study called PNDABLE, researchers wanted to understand how suboptimal social networks can contribute to postoperative delirium (POD) in middle-aged and elderly individuals. They discovered that having poor social ties is a risk factor for POD, much like how poorly maintained roads can lead to traffic jams and accidents. Additionally, the study found that different levels of intimacy within the same social relationship affect certain biomarkers in the cerebrospinal fluid, which plays a role in POD. These biomarkers, like amyloid-β and tau proteins, act as traffic signals regulating the flow of information in the brain. When the social network is suboptimal, these biomarkers become imbalanced, potentially leading to delirium. By understanding these connections, healthcare providers can better support patients by strengthening their social networks before and after surgery. Curious to learn more? Dive into the PNDABLE study and its fascinating findings!

BackgroundAlthough it has been proven that social networks are related to cognition, studies are conducted to characterize the correlation between social networks and postoperative delirium (POD).ObjectiveWe investigated whether suboptimal social networks are a risk factor for POD, and to verify whether different levels of intimacy in the same social relationship can affect the concentration of cerebrospinal fluid (CSF) biomarkers, such as amyloid-β (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau), and the mediating role of CSF biomarkers between social network and POD in middle-aged and elderly Han people.MethodsOur study recruited 743 participants from The Perioperative Neurocognitive Disorder and Biomarker Lifestyle (PNDABLE) study. Confusion Assessment Method (CAM) was used to evaluate the incidence of POD and its severity was measured using the Memorial Delirium Assessment Scale (MDAS). The social networks were measured using self-reported questionnaires about social ties. Mann–Whitney U test, Logistic Regression and Independent-samples test were used for Statistical Analysis.ResultsThe incidence of POD was 20.7%. Mann–Whitney U test showed that the total score of the social network was associated with POD (P < 0.001). Independent-samples test showed that different levels of intimacy in the same social relationship were significantly associated with CSF POD biomarkers, and mediation analyses revealed that the association between suboptimal social networks and POD was partially mediated by T-tau (proportion: 20%), P-tau (proportion: 33%), Aβ42/T-tau (proportion: 14%), and Aβ42/P-tau (proportion: 15%).ConclusionHaving suboptimal social networks is a risk factor for POD in middle-aged and elderly Han people. CSF POD biomarkers can mediate the correlation between suboptimal social networks and POD, which is mainly mediated by tau protein.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR2000033439.

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