The impact of different intervention methods (anesthetic adjuvant drugs, anesthetic techniques, and non-pharmacological interventions) on postoperative cognitive function in patients undergoing cardia

Aging increases the risk of cognitive decline and Alzheimer's disease-related dementias , . Declines in executive function (EF) and processing speed (PS), which are cognitive abilities essential for maintaining independence, often emerge by midlife and are partly driven by age-related deterioration in brain network function , . Early changes in the brain, such as diminished brain network function and reduced modular organization (i.e., the degree to which brain networks preserve distinct communities that enable efficient information processing), are considered indicators of risk for mild cognitive impairment and Alzheimer's disease. These declines reflect neurodegenerative processes of aging, including amyloid-β accumulation, tau pathology, cerebrovascular dysfunction, and white matter deterioration , , . Identifying sensitive time windows to counteract cognitive and brain health decline is therefore essential for sustaining quality of life in aging populations. Importantly, evidence shows that adopting an active lifestyle, especially regular physical activity, represents a promising preventive strategy against cognitive decline. Erickson et al. reported that physical activity was associated with benefits across the lifespan, with consistent neural biomarker improvements at all ages, more robust brain effects in children and adults over 50, and less consistent cognitive benefits in younger adults. Aerobic exercise is a promising strategy for mitigating the adverse effects of aging on brain network function and its associated impact on cognition . The benefits of exercise on brain network function are often evaluated using functional magnetic resonance imaging (fMRI), a non-invasive tool that provides a proxy measure of neuronal activity. By correlating fMRI signals across brain regions, researchers can assess the strength of pairwise communication within and between functional brain networks . Recognizing functional connectivity (FC) as a critical biomarker of brain functionality, numerous neuroimaging studies have examined the effects of aerobic exercise training and cardiorespiratory fitness (CRF), defined as the integrated ability of the cardiopulmonary system to deliver oxygen-rich blood and of peripheral tissues to effectively utilize that oxygen through adaptations such as increased blood volume and enhanced oxidative enzyme activity, on FC in older adults. Studies consistently report that aerobic exercise improves CRF, which in turn demonstrates beneficial effects on the health and integrity of functional brain networks , , , . Moreover, as Won et al. discuss, among older adults aged 60 years and older, improvements in CRF through aerobic exercise interventions lead to enhanced cognitive performance, which may be mediated by increases in FC within brain networks. Collectively, regular aerobic exercise that enhances CRF appears to be a key factor in promoting both FC and cognition among older adults . Many brain networks have been studied in relation to physical activity behavior and CRF, and evidence suggests that these factors can make independent contributions to FC. For example, Voss et al. reported that physical activity levels and CRF each explained unique variance in FC, underscoring the importance of distinguishing between behavioral and physiological influences. The default mode network (DMN) and salience network (SN) are frequently highlighted as being particularly responsive to aerobic exercise interventions , . Cross-sectional studies of older adults aged 55–80 years found that those regularly engaged in aerobic exercise exhibited higher FC within the DMN , , which was associated with better performance on EF tasks . Similarly, a 12-week treadmill walking intervention by Won et al. reported training-induced increases in FC within the SN among healthy older adults with a mean age of 78 years, and these increases were positively correlated with improved immediate recall of logical memory, reflecting enhanced working memory processes. In contrast, other studies have reported mixed results. Chirles et al. observed a decrease in FC within the DMN among older adults aged 60–88 years, while McFadden et al. found no significant changes in FC of the SN in obese young to middle-aged adults with a mean age of 38 years. Won et al. similarly reported no changes in FC within the frontoparietal control network (FPCN) in older adults with a mean age of 78 years, whereas Dorsman et al. observed significant increases in FPCN FC among older adults with an average age of 73 years.