Frailty

The US older population has been rapidly growing and will constitute a fifth of the total population by 2030. It is the fastest growing subset of the population. This rapid increase in the elderly population has a significant impact on the US healthcare system and, as a result, surgeons will frequently encounter senior patients who often present with unique diagnostic and therapeutic challenges. Aging patients have an increased risk of postoperative complications that result in disability, loss of functional independence, diminished quality of life, and death. Accordingly, the postoperative course of such a patient is of cardinal importance because it plays a critical role in determining recovery to complete functional independence. Increasing age and comorbidities also contribute to frailty, which is defined as a decreased physiological reserve and a decline in the resistance to stressors, which is independently associated with poor short-and long-term outcomes after surgery. Early identification of frail geriatric patients will help to identify those who require a more comprehensive and multidisciplinary approach, necessary to adequately address the significant differences in physiology and outcomes presented by this challenging group. The optimal goal for geriatric patients is not only to reduce mortality rates and complications after surgery, but to maintain and preserve a good quality of life after they are discharged, including increasing their ability to return to their preillness level of function and independence.