Geriatric anesthesia is a rapidly growing and evolving field and this is the major revision of a classic anesthesia reference. The last few years have seen significant advancements and important new modalities for addressing the needs of an aging population. The editors of this second edition are uniquely situated to put together a text highlighting both essential knowledge and recent breakthroughs of importance to all who work with the elderly. This edition easily maintains the high standard for quality scholarship and useful material set by the first.

Surgical and anesthetic techniques have evolved to allow a growing number of older adults to undergo surgery, and current estimates are that 50% of Americans over the age of 65 years old will have an operation. However, as the knowledge regarding perioperative care of the elderly surgical patient grows, so do the questions. In this edition, each chapter includes a section entitled “Gaps in Our Knowledge,” meant to highlight areas in which research is needed, as well as hopefully inspire readers to begin solving some of these questions themselves. Building upon the strong foundation of the first two editions, Geriatric Anesthesiology, 3rd edition also assembles the most up-to-date information in geriatric anesthesia and provides anesthesiologists with important new developments.Topics covered include several new chapters that reflect the evolution of multidisciplinary geriatric care throughout the perioperative continuum, as well as the growing body of literature related to prehabilitation. In addition, discussion of the surgeon’s perspective and geriatrician’s perspective on surgery in the geriatric population is covered, as well as the systematic physiologic changes associated with aging and the pharmacologic considerations for the geriatric patient undergoing procedures. Finally, the last section discusses postoperative care specific to the geriatric population, including acute pain management, ICU management, recent evidence and up-to-date practice regarding delirium and postoperative cognitive dysfunction, and palliative care.

The volume of elderly patients requiring anesthesia and surgery is growing rapidly. Thirty-five percent of surgeries are performed on patients older than 65 years, and in general, these patients have higher morbidity and mortality rates after anesthesia compared with their younger counterparts. One of the major challenges of treating elderly patients is the heterogeneity of the geriatric population—and the need to individualize care for each patient to provide the best outcome.

This issue of Anesthesiology Clinics, edited by Dr. Elizabeth Whitlock and Dr. Robert Whittington, in collaboration with Consulting Editor Lee Fleisher, focuses on Geriatric Anesthesia. Topics in this issue include: The Growing Challenge of the Elderly Population; The Perioperative Period; Preoperative Assessment of the Geriatric Patient; Prehabilitation: Optimizing Elders Undergoing Elective Surgery; The Ethics of Surgery at the End of the Life; Perioperative Geriatric Physiology and the Frailty Syndrome; Geriatric Pharmacology; Emergency Surgery in the Elderly; Management of Acute Pain in the Elderly; Special Considerations for the Elderly Brain: Delirium and Perioperative Cognitive Change; Special Challenges of the Geriatric Critical Care Patient; Chronic Pain Management in the Elderly; Providing Patient- Focused Care: Treatment Burdens, Difficult Conversations, and Symptom Management; and Future Directions for Geriatric Anesthesiology.

In this issue of Anesthesiology Clinics, guest editor Dr. Shamsuddin Akhtar brings his considerable expertise to the topic of Geriatric Anesthesia. Top experts in the field cover key topics such as cardiovascular changes in the elderly; perioperative pulmonary complications in the elderly; frailty, sarcopenia, aging, and perioperative outcomes; perioperative delirium; and more. - Contains 18 relevant, practice-oriented topics including central nervous system changes in the elderly: new Insights; data science and geriatric anesthesia research: opportunity and challenges; aging, COVID, and perioperative care; balancing efficiency, empathy, safety, and quality; pain management in the elderly; and more. - Provides in-depth clinical reviews on geriatric anesthesia, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The Manual of Geriatric Anesthesia is a practical guide for physicians, residents, and students interested in the care of the elderly patient undergoing surgery. Although primarily written for anesthesiologists, other perioperative physicians and nurses will also find the information highly valuable. Highlights of the text include concise and clear discussions of preoperative assessment, anesthetic administration, the immediate postoperative care, as well as the more classic ‘geriatric’ topics such as the hip fracture patient, cataract surgery, postoperative delirium, dementia, ethics and end of life care. Clinical geriatric principles are woven into the text so that the reader can develop skills in geriatrics and develop a broader understanding of terminology and principles used in geriatric medicine.

Geriatric Anesthesia: A Practical Guide is a comprehensive reference on geriatric anesthesia. The book is divided into three sections. The first section covers the basics of both anatomical and physiological changes in senescence, and important polypharmacy considerations common in elderly patients. The next section covers anesthesia for cardiac and non-surgical patients. Various controversies and legal ethical issues that are particularly significant in the elderly such as advance directives, code status discussions, specific patient groups and shared decision-making prior to surgical interventions, are covered in the final section. Key features - 20 referenced chapters covering basic geriatric anesthesia considerations, cardiac and non-surgical patients and special topics, respectively - Contributions and references from experienced anesthesiologists - Emphasis on tailoring perioperative management depending on specific circumstances of patients - Addresses novel and commonly overlooked topics related to the geriatric population This book is a guide for both anesthesia providers and non-anesthesia medical providers, trainees and students. It equips them with necessary information to understand and devise anesthetic plans while being aware of postoperative complications and the respective treatment and management options.

Since the publication of the third edition of Geriatric Medicine,extraordinary advances have occurred in the science of aging and the potential for biomedical research to give us answers to many, if not most, of the age-related disorders that threaten the quality of life in older years. At the most basic level, the successful mapping of the human genome was declared complete in the fall of 2000. Understanding the map of the human genome is as important as understanding the map of genomes of important laboratory species, ranging from the microscopic worms and fruit?ies used in most classic genetic studies to rodents such as laboratory mice, and eventually to primates, on which much of the research on the aging human brain is done. The genetic maps of all of these species,including our own,does not answer clinical questions,but it does open the door to dramatic, rapid, and ef?cient answers to questions about the genetic polymorphisms related to diseases in humans. The telomerase story also unfolded since the third edition. Telomerase is an enzyme responsible for maintaining the telomeres—the redundant DNA portions at the end of chromosomes—whose shortening seems to be linked directly to cell senescence,ap- tosis,and the control over cell death,which,at the level of the individual cell,seems to be linked to the decline of organ function and eventually aging and death within the org- ism.

Oxford Textbook of Anaesthesia for the Elderly Patient provides provides a comprehensive and detailed overview of all aspects of anaesthesia for the elderly patient looking at the effect of ageing on the systems of the body and the role that age has on drug mechanisms.

Fractures in the Elderly: A Guide to Practical Management provides geriatricians and other medical specialists who provide care for older adults with the vital guidance and most current data and opinions regarding the treatment of elderly patients who sustain a variety of fractures. It also provides orthopedic surgeons with the necessary information and most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Each chapter is both readable and appealing not only to geriatricians and orthopedic surgeons but to all clinicians that have contact with elderly patients who have sustained or are at high risk of sustaining a fracture. Emphasis is placed on the fact that although in some cases pre- and post-operative care in elderly fracture patient may proceed as it does in younger individuals, often there are considerations owing to functional status, pre-existing conditions, and age-related physiological declines that require specialized knowledge and alternative approaches. Developed by a group of renowned experts, Fractures in the Elderly: A Guide to Practical Management is a major addition to the literature and provides a wealth of specialized knowledge and approaches to care. It is an essential reference for all clinicians who care for older adults as well as fellows and residents in training.