Clinical Guidelines for Perioperative Care of Older and Oldest-Old Patients Living with Frailty Undergoing Elective Surgery

The population of older and oldest-old individuals is increasing at a rapid pace, leading to a notable proportion of this age group requiring surgical procedures due to multimorbidity. It is known that, compared with young people, patients over 60 have a whole set of factors, such as decreased physiological functions, the presence of several concomitant diseases, polypharmacy, cognitive dysfunction and specific geriatric syndromes, which may lead to  a higher risk of  postoperative complications and prolonged recovery. Therefore, an integrated multidisciplinary approach on management is necessary for this group of patients, but the use of such an approach is currently rare. The purpose of this document is to review the literature, summarize current recommendations, and provide a  set of  expert recommendations to  assist practicing geriatricians, surgeons, anesthetists, and allied health professionals.