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Sort of a standard joke; after all, it is hard to
take geriatric anesthesiology seriously. Everyone
takes care of old folks, except perhaps pediatric
anesthesiologists. Perhaps the I.V. is a little
more difficult, you give a little less drug —
no big deal. Is there really anything of interest
in old people?
You bet there is!
Old people are much more diverse than young people.
More and more, our 80- to 90-year-olds are quite
active with many still working and playing sports.
But there also are more old people. The
number of patients over the age of 65 who undergo
noncardiac surgery will increase from 7 million
to 14 million over the next few decades and will
become a very large part of our practice. Under
pressure to achieve new levels of performance and
utilize costly resources more efficiently, we had
better be masters in managing elderly surgical patients.
If we want evidence-based best practices, we had
better encourage investigators and educators to
develop expertise in geriatrics.
| “Under pressure
to achieve new levels of performance and utilize
costly resources more efficiently, we had better
be masters in managing elderly surgical patients.” |
ASA’s Committee on Geriatric Anesthesia is working
to provide the resources necessary to develop this
expertise, both encouraging the expansion of our knowledge
base and disseminating information to our members.
In this issue, we review two areas of research and
new thought and two exciting resources of educational
materials.
On page 6, I discuss current thinking on frailty and
senescence and how we might use these ideas to direct
anesthetic care.
Last year’s Emery A. Rovenstine Memorial Lecturer,
Terri G. Monk, M.D., now at Duke University, brings
us up to date on postoperative cognitive dysfunction,
a syndrome essentially exclusive to the elderly (page
7).
Sheila R. Barnett, M.D., discusses an upcoming consensus
conference on a curriculum for geriatric anesthesiology
that is co-sponsored by the ASA Committee on Geriatric
Anesthesia and the Society for the Advancement of
Geriatric Anesthesia with a grant from the American
Geriatrics Society (page
9).
Michelle A. Adams, the managing editor for an exciting
new Web-based information source, describes how this
product works and what it can do for physicians interested
in geriatric care (page
11).
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Jeffrey H. Silverstein, M.D., is Associate Professor
for Research,Vice-Chair for Research and Associate
Professor of Anesthesiology, Surgery, Geriatrics
and Adult Development at Mt. Sinai School of
Medicine, New York, New York. |
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