Preoperative Management of the Geriatric Patient: Frailty and Cognitive Impairment Assessment

Allison Dalton; Zdravka Zafirova

doi:10.1016/j.anclin.2018.07.008

Preoperative Management of the Geriatric Patient: Frailty and Cognitive Impairment Assessment

Anesthesiol Clin. 2018 Dec;36(4):599-614. doi: 10.1016/j.anclin.2018.07.008. Epub 2018 Oct 12.

Authors

Allison Dalton¹, Zdravka Zafirova²

Affiliations

¹ Department of Anesthesia and Critical Care, University of Chicago, 5041 South Maryland Avenue, MC 4028, Chicago, IL 60637, USA. Electronic address: adalton@dacc.uchicago.edu.
² Section Critical Care, Department of Cardiovascular Surgery, Mount Sinai Hospital System, Icahn School of Medicine, Mount Sinai Medical Center, Box 1028, 1 Gustave L. Levy Place, New York, NY 10029, USA.

PMID: 30390781
DOI: 10.1016/j.anclin.2018.07.008

Abstract

As the population ages, more geriatric patients will be presenting for surgical procedures. Preoperative evaluation seeks to assess patients for geriatric syndromes: frailty, sarcopenia, functional dependence, and malnutrition. Age-related changes in physiology increase risk for central nervous system, cardiovascular, pulmonary, renal, hepatic, and endocrine morbidity and mortality. Identification of various comorbidities allows for preoperative optimization and for opportunities for intervention including nutritional supplementation and prehabilitation, which may improve postoperative outcomes.

Keywords: Frailty; Geriatric; Preoperative evaluation; Sarcopenia; Surgery.

Publication types

Review

MeSH terms

Aged
Aged, 80 and over
Cognitive Dysfunction / diagnosis*
Frailty / diagnosis*
Geriatric Assessment / methods*
Humans
Preoperative Care / methods*
Risk Assessment / methods