{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:08:43Z","timestamp":1785510523606,"version":"3.56.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["91849126"],"award-info":[{"award-number":["91849126"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Postoperative delirium (POD) is a usual complication after total hip\/knee replacement, which may be affected by sleep characteristics. However, up to now, preoperative sleep characteristics have not been evaluated as risk factors of POD. The relationship between self\u2010reported sleep characteristics and POD in patients has been investigated in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We recruited 495 cognitively intact individuals in the final analysis from the Perioperative Neurocognitive Disorder and Biomarker Lifestyle study. Sleep characteristics were tested by the Pittsburgh Sleep Quality Index (PSQI). Mini\u2010mental state examination was applied to assess preoperative mental status of patients. Postoperatively, we used confusion assessment method and memorial delirium assessment scale to evaluate the incidence of POD and POD severity, respectively. The cerebrospinal fluid (CSF) levels of T\u2010tau, P\u2010tau, A\u03b240, and A\u03b242 were detected by enzyme\u2010linked immune\u2010sorbent assay before the operation. Logistic regression, multiple linear regression, and mediation effects were performed to analyze the relationship between self\u2010reported sleep characteristics and POD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>POD was detected in 11.31% (56\/495) of the patients, with logistic regression analysis showing that daytime dysfunction, P\u2010tau, and T\u2010tau were risk factors of POD, and A\u03b242 was a protective factor of POD. Multiple linear regression analysis confirmed that daytime dysfunction was positively correlated with P\u2010tau in patients with POD. Meanwhile, compared to the patients with no postoperative delirium, the CSF levels of P\u2010 and T\u2010tau were higher in patients with POD. Furthermore, mediation analysis showed that it was probable that daytime dysfunction mediated POD through P\u2010tau (proportion: 12.90%) partially.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Daytime dysfunction is a risk factor of POD preoperatively. To sum up, CSF P\u2010tau protein might partially mediate the influence of daytime dysfunction on POD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>This study was registered at Chinese Clinical Trial Registry (ChiCTR2000033439).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3270","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T15:27:55Z","timestamp":1696519675000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Daytime dysfunction may be associated with postoperative delirium in patients undergoing total hip\/knee replacement: The PNDABLE study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0720-4746","authenticated-orcid":false,"given":"Xu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)  Qingdao Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Jing","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)  Qingdao Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Yue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Dalian Medical University  Dalian Liaoning 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