The number of individuals aged 65 years or older in the United States has grown rapidly since 2010. In particular, the 65-and-older population grew by over a third during the past decade.1 With the graying of the nation's population, the number of older patients presenting for surgery also increases. During the preoperative evaluation for this patient population, anesthesiologists are often concerned about the multiple comorbidities that frequently exist in older patients and their impact on perioperative care. A number of underlying conditions raise concerns regarding management during anesthesia and surgery, particularly cardiovascular or pulmonary conditions. However, recent advances in anesthesia, medicine, and surgery have rendered the incidence of perioperative cardiac adverse events to a relatively low level, to less than 3% in unselected patients undergoing non-cardiac surgery.2,3 Similarly, perioperative stroke rate is also infrequent, occurring at less than 3% in non-cardiac and non-carotid surgical patients.4 In contrast,...

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