Medically reviewed by Dr. Julie McSwain, MD, MPH, FASA, August 20, 2024.

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. According to the Centers for Disease Control and Prevention , 38% of surgeries in U.S. hospitals—inpatient and outpatient procedures combined—are now performed on people age 65 or over, and that percentage is expected to increase.

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 can sometimes 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 anesthetics—medication that prevents you from feeling pain during surgery, usually 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 one of the most common complications after surgery in older adults. It is a temporary condition in which the patient is confused, disoriented, and unaware of surroundings and has 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. Certain conditions, including heart disease (especially congestive heart failure), lung disease, Alzheimer’s disease, Parkinson’s disease, and a personal history of stroke, increase your risk for POCD. Researchers in anesthesia care continue to study and learn more about these conditions and how to reduce the risk for POCD in patients who have them.

How can anesthesia risks be reduced in older patients?

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

You might also ask if an anesthesiologist who specializes in or has more experience with older patients 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 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 have experienced with anesthesia in the past. Also talk about any memory problems or cognitive problems you 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 they 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 closely monitor you during the surgery.

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

• Ask your physician to conduct a pre-surgery cognitive test—an assessment of your mental function. The results can be used to help assess your risk for developing postoperative cognitive complications.
• Be sure a family member or friend 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 about taking medications both before and 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.
• If you will be staying overnight in the hospital, pack a family photo or a favorite item from home that can provide familiarity and comfort as you recover from surgery.

Read the Preparing for Surgery page 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.