Preoperative Anesthesia Assessment in Elderly Patients: Challenges and Opportunities for Safer Perioperative Care

As the global population ages, older adults represent an increasing proportion of surgical patients. This demographic presents unique characteristics that increase their risk for postoperative complications, including delirium, functional decline, and mortality. Frailty has emerged as a key predictor of adverse outcomes, reflecting diminished functional and physiological reserves. Cognitive impairment, particularly when combined with frailty (cognitive frailty), further increases the risk, yet routine preoperative screening remains uncommon. This review examines the limitations of traditional preoperative evaluations in older adults and emphasizes the value of incorporating frailty and cognitive assessments using validated tools for more accurate risk stratification. Early identification of these factors may facilitate targeted interventions, ultimately improving postoperative recovery and functional recovery in this vulnerable population.