{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:31:59Z","timestamp":1788402719972,"version":"build-2803163510"},"reference-count":32,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004801","name":"Shota Rustaveli National Science Foundation","doi-asserted-by":"publisher","award":["FR-21-14437"],"award-info":[{"award-number":["FR-21-14437"]}],"id":[{"id":"10.13039\/501100004801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,2]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In high-income countries, the prevalence of frailty ranges from 10% to 37%. However, data from low- and middle-income countries remain largely unavailable, and no information is currently available on the prevalence of frailty or cognitive impairment in the Georgian population. Preoperative frailty is a known risk factor for postoperative delirium and neurocognitive disorders, which can be life-threatening in the population of older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol describes a prospective, single-centre observational cohort study investigating preoperative frailty and postoperative neurocognitive disorders in older adults presenting for surgery in Georgia. The study will include 230 participants. Patients will be enroled after their cognitive health is evaluated using the Montreal Cognitive Assessment test. Frailty and neuropsychological tests are conducted at baseline, discharge, 30 days, 3\u2009months and 12\u2009months postoperatively. Additionally, IL-6 levels are measured in blood samples to assess systemic inflammatory levels preoperatively. Participants will be followed up for 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Our trial has been approved by the Ethics Committee of the LTD \u2018New Hospitals\u2019 clinic (Approval No. 23\/01). Patient recruitment began in April 2023 in Tbilisi, Georgia, and will continue until 2026. Dissemination plans include presentations at scientific conferences, publication in peer-reviewed journals, engagement with stakeholders and outreach through popular media.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06700291\">NCT06700291<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101245","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:00:27Z","timestamp":1761033627000},"page":"e101245","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Preoperative frailty and postoperative neurocognitive disorders in older adults in Georgia: study protocol for a prospective, observational cohort study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06700291","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06700291","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Tamta","family":"Darsalia","sequence":"first","affiliation":[{"name":"David Tvildiani Medical University, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9051-7913","authenticated-orcid":false,"given":"Lisbeth","family":"Evered","sequence":"additional","affiliation":[{"name":"Dept. 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