Skip to Main Content

++

INTRODUCTION

++

In the past several decades, there has been a dramatic increase in the percentage of the world's population that is elderly, defined as people 65 years or older. This trend is projected to continue to increase in the future.1 Understanding core principles of perioperative care of the elderly, particularly in the context of clinical pharmacology, will become increasingly more important for clinicians.

++

PHYSIOLOGIC CHANGES WITH AGING

++

As people age, there are important changes in physiology and response to pharmacologic interventions. Aging consists of the deterioration or loss of functional units (eg, neurons, nephrons, or alveoli) at the cellular, tissue, or organ level, as well as disruption of regulatory processes at the molecular level.2 Basal organ function, in the otherwise healthy individual, is relatively preserved with aging,3 but functional reserves and the ability to tolerate stress, such as occurs with anesthesia and surgery, declines significantly with age. However, with regard to organ function, wide intraindividual and interindividual variability does exist.4 That is, biologic age does not linearly correlate with physiologic or medical age. The geriatric population is unique in its physical and medical heterogeneity, which only increases with advancing age. Acute or chronic disease states, genetics, environmental, socioeconomic and likely countless other factors play into the rate or degree of organ function decline. Advanced age, nevertheless, has been shown by many studies to be an independent predictor of perioperative outcome (Table 25–1).

++
Table Graphic Jump Location
Table 25–1Physiologic changes with age and associated clinical consequences.

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.