Poor nutritional status, as indicated by low serum albumin levels or malnutrition, has been identified as a risk factor for POD.[41] Malnutrition can lead to impaired immune function, delayed wound healing, and reduced cognitive reserve, all of which can contribute to the development of POD.[42] Preoperative anemia has also been associated with an increased risk of POD, possibly due to reduced oxygen delivery to the brain.[43]. The gene discussed is ALB; the disease is anemia (phenotype).