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The Growing Challenge of the Older Surgical Population. The population of older adults is rapidly growing. With the continued advancement of medical and surgical interventions, the average age of this population will continue to increase. Nearly one-third of surgical procedures are performed in older adults. Physiologic changes, multiple comorbidities, frailty, and postoperative cognitive dysfunction affect an elderly patient's postoperative recovery. Anesthesia providers can play a key role in creating perioperative geriatric pathways. The perioperative care of a geriatric patient is associated with unique and anesthetic risks. Perioperative care must be tailored to individual patients to reduce perioperative complications in this important, vulnerable population.