[Pharmacological peculiarities and problems with older patients]

Area of Science:

• Geriatric Medicine
• Anaesthesiology
• Public Health

Context:

• The German population is aging rapidly, with individuals over 65 projected to reach 20% by 2025 and double by 2030.
• Elderly patients frequently present with multi-morbidity and age-related physiological changes affecting renal, cardiovascular, and hepatic functions.
• These demographic shifts significantly impact the demands on anaesthesiologic procedures and perioperative management.

Purpose:

• To highlight the challenges in anaesthetic management for the growing elderly population.
• To discuss the increased risks of perioperative complications, including cardiovascular events and postoperative cognitive dysfunction (POCD), in older adults.
• To explore the potential benefits of regional anaesthesia over general anaesthesia in this demographic.

Summary:

• The increasing proportion of elderly individuals necessitates careful consideration of age-specific physiological alterations and co-existing conditions during anaesthesia.
• Postoperative cognitive dysfunction (POCD) is a significant concern due to its patient and economic implications.
• Regional anaesthesia demonstrates potential advantages, including reduced thromboembolic and respiratory complications, compared to general anaesthesia for elderly patients.

Impact:

• Informs anaesthesiologists about the evolving patient demographics and associated perioperative risks.
• Emphasizes the need for tailored anaesthetic strategies to mitigate complications in the elderly.
• Suggests regional anaesthesia as a potentially safer alternative, contributing to improved patient outcomes and reduced healthcare costs.