The older a person gets, the more likely it is that they will develop health problems. Chronic conditions like cardiovascular disease, diabetes, and osteoarthritis become more common, increasing the odds that surgery will be suggested to address complications of ongoing health issues. Among those who have surgery, 1 in 10 is over age 65. Unfortunately, old age can also increase the chances that a patient will suffer complications during or after surgery related to the use of anesthesia. Understanding the risks can help you make informed choices about your healthcare to preserve your well-being.
What Factors Increase Anesthesia Risk for Older People?
Certain factors increase the risk of complications from anesthesia at any age. These include diabetes, heart disease, clogged arteries, high blood pressure, kidney problems, lung conditions such as chronic pulmonary obstructive disease (COPD), obesity, obstructive sleep apnea, and more. Because older individuals tend to suffer from one or more of these conditions more often than younger people do, the risks posed by surgery are correspondingly higher as well.
However, these risks are not necessarily the most concerning among older patients. Elderly patients are much more likely to suffer from cognitive side effects for surgery because the aging brain is more vulnerable to anesthesia. Postoperative delirium is a temporary condition in which the patient is disoriented, confused, and unaware of their surroundings. They also experience problems with attention and memory. Symptoms may not appear until a few days after surgery and may also come and go. However, they usually disappear after about a week.
Other seniors may develop a more serious condition known as postoperative cognitive dysfunction (POCD) after surgery. This can cause long-term problems with memory, attention, concentration, reflexes, learning, and thinking. Having certain conditions such as heart disease (especially congestive heart failure), lung disease, Parkinson’s, or having had a previous stroke can increase the odds of developing POCD. It can be difficult to determine if a patient has POCD, as its symptoms are similar to those older people may already be experiencing prior to surgery. Conducting a mental evaluation prior to surgery to establish a baseline for comparison is necessary for an accurate assessment of a decline in function.
Lowering Anesthesia Risks for Seniors
Should surgery be necessary, it can be possible to reduce the risk of age-related anesthesia complications. Patients are strongly advised to share complete information about their health conditions, current medications (including nonprescription drugs and supplements), any previous adverse reactions to or memory problems after anesthesia experienced in the past. Some medications may need to be discontinued or substituted prior to surgery. If possible, patients should also request an anesthesiologist with experienced in caring for older patients to manage their care. Patients should also be carefully monitored by a caregiver, relative, or friend during recovery to detect and report any troubling symptoms to the patient’s healthcare provider.
However, when multiple risk factors are present, or patients are concerned about adding possible cognitive side effects to the grueling physical recovery from surgery, it may be advisable to explore if both surgery and general anesthesia can be avoided altogether. At the Vein & Fibroid Treatment Center, board-certified vascular and interventional radiologist Dr. Omar Saleh specializes in minimally invasive procedures that do not require general anesthesia for conditions such as peripheral artery disease (PAD), osteoarthritis of the knee, and benign prostatic hyperplasia (BPH, also known as enlarged prostate). These outpatient treatments allow patients to effectively address health concerns without having to endure large incisions, lengthy hospital stays, and grueling postsurgical recovery. After their procedure, patients can go home to recover in comforting surroundings with familiar faces, rather than the disorienting environment of a hospital or rehab facility.
If you are faced with the possibility of surgery—or if an elderly loved one is—and you’re worried that anesthesia or the procedure itself will rob you of the quality of life you’re trying to preserve, there may be an alternative. Schedule a consultation at the Vein & Fibroid Treatment Center to learn about your options today.