Age

Age may bring wisdom but it also brings a greater chance of health problems, and some health problems might require surgery to make you better. In fact, 1 in 10 people who have surgery are 65 or older.

While being older makes surgery more likely, it can also increase your potential for risks during procedures. Some common health problems related to aging — increased blood pressure, clogged arteries, and heart and lung disease — may make it more likely that you’ll experience side effects or complications during or after surgery. And, just being older sometimes can cause some distressing side effects.

Some common health problems related to aging may make it more likely that you’ll experience side effects or complications during or after surgery.

Do anesthesia risks increase in older adults?

One concern for older patients is that the aging brain is more vulnerable to anesthesia, medication that prevents you from feeling pain during surgery often by sedating you or making you lose consciousness. Here are two anesthesia-related surgery risks that are more common in older people:

• Postoperative delirium – This is a temporary condition that causes the patient to be confused, disoriented, and unaware of surroundings, and have problems with memory and paying attention. It may not start until a few days after surgery, may come and go, and usually disappears after about a week.
• Postoperative cognitive dysfunction (POCD) – This is a more serious condition that can lead to long-term memory loss and make it difficult to learn, concentrate, and think. Because some of these problems are already common in elderly people, the only way to determine if a patient actually has POCD is to conduct a mental test before surgery. Certain conditions, including heart disease (especially congestive heart failure), lung disease, Alzheimer’s disease, Parkinson’s disease, and having had a stroke in the past, increase your risk for POCD. Researchers in anesthesia care continue to study and learn more about these conditions and how to prevent or reduce the effects.

How can you reduce anesthesia risks in older patients?

The most important thing you can do to reduce risks of anesthesia is talk to your physician or surgeon to be sure your anesthesia care is led by an anesthesiologist.

You might also ask if there’s an anesthesiologist who specializes in geriatric patients, or has more experience with older patients, who can manage your care. Steps can be taken before, during and after surgery to help reduce your risks of developing age-related problems from anesthesia.

During your meeting with your anesthesiologist before surgery, be sure to talk about any health problems you might have, all the medications you take, including nutritional or herbal supplements, and any concerns or fears you might have about your surgery. Describe any surgeries you’ve had and any problems you may have experienced with anesthesia in the past. Also talk about any memory problems or thinking problems you may have experienced after having anesthesia.

It’s a good idea to have someone with you during these meetings, preferably a close family member or friend. This person could tell the anesthesiologist something you forgot to mention or didn’t think was important, and might also have helpful observations about your health or behavior. A second pair of ears will also help you remember what the anesthesiologist told you, including instructions for preparing for surgery.

Your anesthesiologist will use the information you provide to develop the best anesthesia care plan for you, to reduce your risk of complications, and then closely monitor you during the surgery.

Other steps you can take to eliminate complications and reduce confusion include the following:

• Ask your physician to conduct a pre-surgery cognitive test — an assessment of your mental function. The physician can use the results as a baseline for comparison after surgery.
• Be sure your caregiver or person who spends the most time with you stays with you as you recover, carefully observes your physical and mental activity after surgery and reports anything troubling to your physician.
• Check with your physician before taking medications after surgery that can affect your nervous system, such as those for anxiety, seizures, muscle spasms, and difficulty falling asleep.
• If you wear hearing aids or glasses, ask that they be made available to you as soon as possible after the procedure.
• Request a recovery room with a window if possible, so you can tell whether it’s day or night.
• If you will be staying overnight in the hospital, pack a family photo, a clock, and a calendar, or other familiar objects from home, to help you readjust.

See Preparing for Surgery for more information.

Anesthesiologists work with your surgical team to evaluate, monitor, and supervise your care before, during, and after surgery—delivering anesthesia, leading the Anesthesia Care Team, and ensuring your optimal safety.