postoperative cognitive decline is a common and deleterious complication in aged patients.The link between inflammation and postoperative cognitive decline has also been reported.However,the link between SOD1，SOD2，Osteopontin， Kallikrein-6，and Contactin-1 and postoperative cognitive decline is unknown. In this project ,investigators examine the relationship between 5 cytokines measured at there timepoints (preoperative [PREOP], postoperative day 1 [POD1] , and postoperative day 3[POD2]) and postoperative cognitive decline among older adults undergoing orthopedic surgery.

Inclusion Criteria:

• patients who are more than 65 years old
• patients who undergo orthopedic surgery(trauma ,especially fracture of lower limb)
• patients with ASA physical status I-III
• patients who have a consent

Exclusion Criteria:

• patients who are more than 85 years old
• patients with ASA physical status >III
• patients who have neurological disorders, stroke or other affective central nervous system diseases
• patients who have a history of serious psychiatric illness
• patients with long-term use of psychoactive substances
• patients who undergo multiple trauma and the presence of head injury

aged patients who recieve surgery for orthopedic surgery under spinal or general anesthesia