Alvarado Mora María Luisa, Alvarado Fernández María Laura, Apuy Rodríguez Fiorella, Arias Alvarado María Jesús, Arias Valverde Jessica
Faculty of Medicine, University of Costa Rica, San José, CRI.
Cureus. 2025 Jul 31;17(7):e89174. doi: 10.7759/cureus.89174. eCollection 2025 Jul.
As the global population ages, older adults represent an increasing proportion of surgical patients. This demographic presents unique characteristics that increase their risk for postoperative complications, including delirium, functional decline, and mortality. Frailty has emerged as a key predictor of adverse outcomes, reflecting diminished functional and physiological reserves. Cognitive impairment, particularly when combined with frailty (cognitive frailty), further increases the risk, yet routine preoperative screening remains uncommon. This review examines the limitations of traditional preoperative evaluations in older adults and emphasizes the value of incorporating frailty and cognitive assessments using validated tools for more accurate risk stratification. Early identification of these factors may facilitate targeted interventions, ultimately improving postoperative recovery and functional recovery in this vulnerable population.
随着全球人口老龄化，老年成年人在外科手术患者中所占比例日益增加。这一人群具有独特的特征，增加了他们术后并发症的风险，包括谵妄、功能衰退和死亡。衰弱已成为不良结局的关键预测因素，反映了功能和生理储备的减少。认知障碍，尤其是与衰弱（认知衰弱）相结合时，会进一步增加风险，但术前常规筛查仍然不常见。本综述探讨了传统术前评估在老年成年人中的局限性，并强调了使用经过验证的工具纳入衰弱和认知评估以进行更准确风险分层的价值。早期识别这些因素可能有助于采取有针对性的干预措施，最终改善这一脆弱人群的术后恢复和功能恢复。
