Abstract
PURPOSE: The identification of older patients who may have deficits in cognitive or functional domains will become more pressing as increasing numbers of these patients present for preoperative evaluations. The number of older adults with deficiencies in these areas is projected to grow, and more of these patients will present for assessment in preoperative clinics with the expectation that surgeries will be performed. METHODS: We review current outcomes data for preoperative cognitive impairment and frailty. FINDINGS: We point to a number of directions research is taking as systems for the prevention of postoperative cognitive and functional decline are being developed. We also discuss the current status of screening and examine potential instruments that can be used in the setting of the preanesthesia clinic. IMPLICATIONS: Clinicians may anticipate that geriatric screening tools focused on cognitive and functional domains will play a direct role in the ongoing evolution of presurgical assessment and triage.