Susana Vacas, MD, PhD

“To be most effective, these strategies require family engagement and involvement of this interdisciplinary health care team. One example is the family and support system—if there are concerns, for example, it should be up to the health care team, the perioperative team, to refer to a social worker or [provide] any care [that] patients might need.”

The need to address and optimize potential risk factors for older patients ahead of surgery is vital, as this population may have modifiable factors that require attention from both surgeons and anesthesiologists. According to Susana Vacas, MD, PhD, assistant professor of anesthesiology, David Geffen School of Medicine, University of California–Los Angeles, these strategies are most effective when they involve family members as well as the health care team.

Maintaining a healthy lifestyle is recommended by the World Health Organization, Vacas noted, specifically managing a patient’s blood pressure and diabetes, as well as integrating physical activity into the daily routine. The need to optimize these risk factors preoperatively was emphasized, as patients who are at high risk for developing these conditions, specifically those that are over the age of 65 years, should trigger evaluation and/or optimization. 

Vacas S, Cole DJ, Cannesson M. Cognitive decline associated with anesthesia and surgery in older patients. 

. 2021;326(9):863-864. doi:10.1001/jama.2021.4773

Videos

Following the publication of a recent article outlining the association of the use of anesthesia during surgery and cognitive decline in older adults, the assistant professor of anesthesiology at the David Geffen School of Medicine, UCLA, spoke on the need to assess risk factors. [WATCH TIME: 5 minutes]

Improving Surgery Communication, Risk Factor Assessment for Older Adults: Susana Vacas, MD, PhD

“What we know now is that first, we estimated about 40% of the cognitive issues seen after surgery can be preventable. [This is] important in that the outcomes for these diseases lead to longer hospitalization. Actually, in older populations, it's been linked to an increased risk of mortality 1 year after surgery, and risk of premature leaving of work.”

Surgery and the accompanying anesthesia can be utilized to improve the lives of older adults; however, the aging population also faces associated risks when undergoing these procedures, as postoperative neurocognitive disorders (PNDs) remain a concern. Susana Vacas, MD, PhD, sat down with 

 to discuss findings from a recent article, of which she was the corresponding author, where she and colleagues outlined the need to assess potential risks ahead of surgical procedures. 

Vacas, who is an assistant professor of anesthesiology at the David Geffen School of Medicine, University of California–Los Angeles, further called attention to the needs of patients’ caregivers in addition to patients themselves. Older adults experiencing postoperative delirium, for example, may go to the grocery store and forget what it is that they needed or forget other aspects of daily living activities. Delirium is also associated with high health care and hospital costs, she said, with an estimated 65% of patients 65 years and older experiencing the symptoms.

Vacas S, Cole DJ, Cannesson M. Cognitive decline associated with anesthesia and surgery in older patients. 

The assistant professor of anesthesiology at the David Geffen School of Medicine, University of California–Los Angeles, discussed a recently published article that outlined an association between anesthesia during surgery and cognitive issues. [WATCH TIME: 4 minutes]

Susana Vacas, MD, PhD

Articles

Improving Surgery Communication, Risk Factor Assessment for Older Adults: Susana Vacas, MD, PhD

Surgical Anesthesia and Cognitive Decline in Older Adults: Susana Vacas, MD, PhD

Latest News