Summary: Long-term cognitive decline after surgery and anesthesia is a feared outcome particularly relevant for older patients.  It has canonically been suspected that anesthetics are responsible, but growing high-quality evidence suggests this may not be the case.  If not anesthetics, then what?  This talk describes the evidence and suggests how a new view of surgery in the context of older patients' lives may lead to a more patient-centered approach to the risk of cognitive change.

Objectives: Participants will:

1. Integrate our current understanding of postoperative cognitive change in older adults with recent data from epidemiological studies and patient anecdote.
2. Recognize where the knowledge gaps regarding perioperative counseling about cognitive change exist.
3. Learn to approach discussion of long-term postoperative cognitive outcomes from a patient-centered perspective.