Author Reply to Comments on “Association between preoperative frailty and postoperative delirium and cognitive dysfunction in elderly patients undergoing surgery under general anaesthesia”

We appreciate Kumar et al. for their thoughtful observation and comments[1] on our published study.[2] The conclusion in the abstract meant to emphasise that the hypothesis was proved right, and the hypothesis was that frailty would be associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The higher odds ratio (OR) of frailty with POD (OR: 2.93) and POCD (OR: 5.38) displays the strength of this association, as rightly identified by Kumar et al. However, in no possible way was causation implicated. Similarly, Fu et al.[3] demonstrated a pooled adjusted OR of 3.23 for delirium in frail patients. This was discussed in detail in the current study, and, in fact, it concluded that frailty could predict POD and POCD in elderly patients undergoing non-cardiac surgery; therefore, routine frailty assessment should be considered in such patients. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Presentation at conferences/CMEs and abstract publication None. Study data availability De-identified data may be requested with reasonable justification from the authors (email to the corresponding author) and shall be shared upon request. Disclosure of use of artificial intelligence (AI)-assistive or generative tools The authors confirm that no AI tools or language models (LLMs) were used in the writing or editing of the manuscript, and no images were manipulated using AI. Declaration of use of permitted tools The scales, scores, figures, and tables in the original articles are freely available and not copyrighted. Authors contributions AK, Data collection, data analysis. Manuscript preparation, review and editing; DKB, Concept formation, review and editing; RV, Concept formation, review and editing; BKR, Review and editing; RKA, Review and editing; AKS, Review and editing; SM, Concept formation, data analysis, review and editing; PK, Concept and methodology preparation, data collection and review.