Global demographic changes have resulted in an older, frailer surgical population with significant multimorbidity causing higher frequency of adverse postoperative outcomes. The need for restructuring of perioperative care pathways to address this issue has been recognised. Comprehensive geriatric assessment (CGA) and optimisation are emerging as innovative perioperative pathways. This paper describes one centre’s approach in applying CGA in the surgical setting and presents the evidence in support of this. Similar models are being established in Singapore in hip fracture, colorectal and vascular populations. The challenges in the widespread adoption of such models of care are similar across settings. The global nature of translation is also discussed in this paper.
The global challenges of an ageing population are
well known. Economic growth and advances in medical
treatments have brought about a 2-decade increase in
worldwide life expectancy at birth since 1960. This
extension of the “third age” results in a higher comorbidity
burden in the context of age-related physiological changes,
and people often live with health-related issues in these
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