Cognitive impairment and its adverse outcomes in older surgical patients: an under-recognized problem!

Abstract

The older population, aged 65 years or older, is projected to nearly triple from 524 million in 2010 to 1.5 billion by 2050, representing 8.5% to 16.7% of the global population, respectively. 1 This increase is particularly pronounced in comparison to the trend of the younger population aged 20 years or below, which is estimated to remain relatively static from 2.5 billion in 2015 to 2.6 billion in 2050. With the increase in life expectancy, the number of individuals with cognitive impairment (CI) has increased by 117% in the last 25 years. 2 It will continue to increase with the aging forecast. The susceptibility of older individuals to develop CI partly derives from the complexity of the aging process. Aging involves in fl ammatory and physiological changes across multiple organ systems including the brain, ren-dering the older population more vulnerable and less resilient to future in fl ammatory insults. 3 Globally, 313 million surgeries are performed with 4 million postoperative deaths and