Pathophysiological changes in the elderly.
Demographic data indicate an increasing workload of geriatric anaesthesia due to advancing life expectancy and reduced thresholds for high-invasive and high-risk surgery in the elderly. Chronological and biological age may be inconsistent, and the existence of age-related changes may vary between organ systems in the same individual. Age itself is not an illness, but is the most important contributing factor for perioperative complications and adverse outcome when the overall narrowed margins of organ function reserve are transgressed during the perioperative period. Age-related changes in the cardiovascular, pulmonary, nervous, metabolic and locomotive systems that are frequently present in the elderly are discussed with regard to their potential relevance to anaesthesiology. In conclusion, listing current diagnoses will not be sufficient in the assessment of the geriatric patient because age-related changes do not necessarily manifest as pathological entities. Rather, pre-operative examination should focus on determination of individual margins of organ function reserve.
Tonner
Peter H
PH
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Kiel, Schwanenweg 21, D-24105 Kiel, Germany.
Kampen
Joerg
J
Scholz
Jens
J
D000368:Aged; D000375:Aging / Q000378:metabolism / Q000502:physiology*; D000758:Anesthesia; D003710:Demography; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male