Effects of personality on development of postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal surgery

Abstract

Objective To evaluate the effects of personality on the development of postoperative cognitive dysfunction (POCD) in elderly patients undergoing gastrointestinal surgery. Methods Fifty-eight elderly patients, aged 65-70 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Eysenck Personality Questionnaire (EPQ) P rating scale score <50, scheduled for elective gastrointestinal surgery under general anesthesia, were enrolled in the study.Personality was assessed by using EPQ at 1 day before surgery.By using a 2 × 2 factorial design, 2 empirical factors introversion or extroversion (factor A) and neuroticism (factor B) were used.A1 and A2 were introversion (EPQ E rating scale score<50) and extroversion (EPQ E rating scale score≥50), respectively.B1 and B2 were emotional stability (EPQ N rating scale score<50) and emotional instability (EPQ N rating scale score≥50), respectively.The patients were divided into 4 groups: A1B1 group (n=8), A1B2 group (n=10), A2B1 group (n=26), and A2B2 group (n=14). Cognitive function was assessed at 7 days after surgery, and the development of POCD was recorded. Results The incidence of POCD was 0, 0, 15% and 57% in A1B1, A1B2, A2B1 and A2B2 groups, respectively, the incidence of POCD was significantly higher in group A2B1 than in A1B1 and A1B2 groups, and the incidence of POCD was significantly higher in group A2B2 than in the other three groups (P<0.05). Factor A and factor B produced effects on the development of POCD(P<0.01), and an interaction between them was found (P<0.01). Conclusion The incidence of POCD is higher for the non-mentation patients who are extroverted and emotionally unstable. Key words: Personality; Aged; Cognition disorders; Postoperative complications