Editorial: Anesthesia for the older surgical patient: beyond standard care?

DOI:10.1097/ACO.0000000000000948 By the year 2024 people 65 years and older will represent over a quarter of the global population. Soon, we will have more older people than children and more peopleat theextremesof old age than ever before. This trend in population ageing will undoubtedly translate into increasing numbers of older adults in developed countries requiring invasive and minimally invasive procedures for revascularization-related, joint repair and replacement-related, urologic and gynecologicrelated, gastrointestinal-related and ophthalmologicrelated surgeries, and more. One of the major challenges of treating older patients is the heterogeneity of the geriatric population – and the need to individualize care for each patient to provide the best outcome. Indeed, the incidence of comorbidity increases with age, so does the risk for postoperative complications which further underscores the central role anesthesiologists are certain to play, moving forward as gerontological-perioperativists in the care of the older surgical patient. Having instinctual perceptiveness and exceptional procedural skills ranging from preoperative preparation, intraoperative anesthetic management, and postoperative pain management to intensive care, anesthesiologists are well suited to ensure consistent, coordinated, and integrated care throughout the entire perioperative period of these patientsso theycanreturn toanoptimalqualityof life. The current concept is very near and dear to my heart having recently moved my 87-year-old mother and her 90-year-old husband to my city and integrating them into multi and interdisciplinary medical management teams, and coordinating same-day surgery care, to help them to continue to thrive independently. To this end, having a thorough understanding of the needs, complications, and physiologic changes in the older patient requires continuing education in topics surrounding geriatric perioperative medicine. This series in CurrentOpinions inAnesthesiology will, I hope, offer a platform for that. We start with an up-to-date review by Einav et al. [1] of findings from across the globe on in and out of hospital cardiac arrest and outcomes of older adults. While older age does not justify withholding cardiopulmonary resuscitation, these authors stress the importance of a shared decision-making process