Social Cognitive Dysfunction in Elderly Patients After Anesthesia and Surgery

Delin Zhang, Jun Ying, Xiaochi Ma, Zaifeng Gao, Hanjian Chen, Shengmei Zhu, Liping Shi, Xiqian Lu, Delin Zhang, Jun Ying, Xiaochi Ma, Zaifeng Gao, Hanjian Chen, Shengmei Zhu, Liping Shi, Xiqian Lu

Abstract

Extensive studies have revealed that cognitive processing was impaired after anesthesia and surgery, particularly for the elderly patients. However, most of the existing studies focused on the general cognitive deficits (e.g., delayed neuro-cognitive recovery and POCD). Although diagnosis of social abilities has been used in various clinical fields, few studies have investigated the potential deficit on social cognition after anesthesia and surgery. The current study examined whether there was any social cognitive dysfunction after anesthesia and surgery. We achieved this by taking biological motion (BM) as the stimuli of interest, the perception of which has been taken as the hallmark of social cognition. The elderly patients (aged ≥ 60 years) were required to judge whether an upright BM stimulus appeared among the dynamic noises to test their social cognition, as well as do a Mini-Mental State Examination to test their general cognition. The two tests were performed at both 1-day before and 7-day after the surgery. Results showed that 31.25% of patients exhibited BM perception deficit after anesthesia and surgery relative to before anesthesia and surgery, implying that social cognitive dysfunction existed. Meanwhile, social cognitive dysfunction was independent from delayed neurocognitive recovery.

Keywords: anesthesia and surgery; biological motion; delayed neurocognitive recovery; holistic processing; social cognition.

Copyright © 2020 Zhang, Ying, Ma, Gao, Chen, Zhu, Shi and Lu.

Figures

FIGURE 1
FIGURE 1
BM perception task with a scrambled mask. The red human figure is presented in white in the real experiment. Dynamic BM demos can be found in Supplementary Material.
FIGURE 2
FIGURE 2
The detection of BM under different measure times and different orientations of BM stimuli for SCD and non-SCD group, respectively. For each box plot, the top line showed the maximum of the data, the box means the range from third quartile to first quartile, the line inside the box showed the median, the bottom line showed the minimum of the data, and there was no outlier according to the 1.5 inter-quartile range criterion. The scatter figure showed the data from every patient.
FIGURE 3
FIGURE 3
(A) The correlation analysis between inversion effect of BM and the MMSE score in pre-operative phase. (B) The correlation analysis between the inversion reduction and MMSE decrease between pre- and post-operative phases. The dotted lines showed 95% CI of simple linear regression.

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