Anaesthesia for elderly patients

The subspecialty of geriatric anaesthesia is becoming part of mainstream anaesthesia and perioperative care. The number and complexity of elderly patients presenting for anaesthesia is increasing. This increase is due to increased life expectancy and an older population presenting for surgery, who have diminished physiological reserves and increased underlying comorbidity. The operative mortality and prevalence of postoperative complications are increased in elderly patients undergoing elective surgery. Ageing affects all organs, therefore when planning anaesthesia it is important to consider the effects of ageing on all systems. It is not uncommon for elderly patients who seem fit to decline after an operation. This article summarizes the physiological effect of ageing using a system-based approach. The risks of anaesthesia and surgery associated with increasing age are outlined, and an approach to minimize morbidity and mortality is recommended.