PND is a common and serious neurological complication in elderly patients during the perioperative period, significantly affecting postoperative cognitive function. Currently, the diagnosis of PND primarily relies on cognitive function tests, which have limitations due to their subjectivity and time-consuming nature. Therefore, identifying objective and effective biomarkers for PND is crucial for the early identification of high-risk patients and providing a scientific basis for timely intervention and treatment.

The expert consensus panel comprises 25 international experts from various fields, including anesthesiology, neuroscience, geriatric medicine, psychiatry, and rehabilitation medicine. Through face-to-face and online meetings, the experts identified relevant keywords and determined key biomarkers for PND. The panel conducted a comprehensive literature review, covering 194 relevant clinical studies published from January 2000 to October 2024.

This article synthesizes the panel's insights on PND, presenting the latest clinical evidence across three dimensions: imaging, electroencephalography, and molecular markers. It also explores the relationship between PND and other age-related cognitive impairments. By thoroughly reviewing PND studies, the panel identified biomarkers with high sensitivity and specificity, establishing a solid scientific foundation for predicting and diagnosing PND.

The article emphasizes that future research should focus on large-scale randomized controlled trials to explore combinations of various biomarkers, aiming to improve the accuracy of early PND detection. Additionally, establishing standardized testing procedures and evaluation frameworks will promote the clinical application of PND biomarkers and enhance brain health in the aging global population. Future studies should also address risk assessment for high-risk patients, evaluate clinical treatment outcomes, and facilitate rapid clinical diagnosis. Exploring new biomarkers and therapeutic interventions will provide strategies to reduce the incidence of PND. This article offers a fresh perspective on the early identification and intervention of PND, and we look forward to future research further advancing the clinical application of PND biomarkers to improve postoperative cognitive health in elderly patients.