Geriatric anesthesia: minimizing the risk.

Aging is an all-encompassing, multifactorial process involving a decreased capacity for adaptation and a gradual decrease in functional reserve of all the body's systems. Aging itself is not truly a disease process but is instead an index of the probability of many disease states. Underlying disease is not always clinically evident in the elderly. Increased operative risk, when present, is attributable to identifiable disease, not simply to the aging process. A thorough understanding of the expected physiologic deviations from the norm must be the benchmark for the anesthesiologist, surgeon, and consultant in formulating a treatment plan. Deviations exceeding those expected must be dealt with cogently by this health care team. It is, therefore, extremely important to establish and maintain communication and understanding among the care team, the patient, and the family. With this approach, we can minimize the risks of anesthesia in the elderly.