Before the Operating Room: Geriatrics & Prehabilitation Sunday, May 1, 7:30 - 9:00 am CME Credit Hours: 1.5 By 2030, adults older than 65 years will exceed 20% of the U.S. population. In parallel to this rapidly-changing demographic, rates of surgery in this population are expected to increase by as much as 30%. Older adults are at highest risk of poor or unwanted outcomes when treatments are inadequately personalized. Failure to provide appropriate surgical care to older adults may be driven by the unique complexities of balancing an individual’s diagnosis, preoperative risk assessment, the decision to pursue surgery, and perioperative care considerations. A lack of appreciation for this complexity has led to systemic undertreatment (i.e., excluding patients due to chronological age) and overtreatment (i.e., not accounting for individual vulnerabilities or preferences) among older patients with surgical diseases. In general, the decision to pursue surgery should be based on multidimensional health status and frailty rather than chronological age with the overall goal of optimal surgical care while maintaining functional independence. This symposium will provide an overview of frailty and physiological stress, outcomes of importance to older adult patients, namely quality of life and functional recovery, and describes useful care models for surgery in older adults. Throughout the symposium, speakers will provide a stepwise guide for surgeons among other providers to integrate older adult specific care into their practices. Objectives At the conclusion of this session, participants should be able to: Define optimal goals of surgery among older adults such as functional recovery and maintaining quality of life. Recognize various frailty tools to provide personalized surgical care to older adults. Identify specific practices in an effort to achieve the optimal goals of surgery among older adults Agenda Co-Directors: Nicole Saur, MD, Philadelphia, PA Amy Suwanabol, MD, Ann Arbor, MI 7:30 am Introduction Nicole Saur, MD, Philadelphia, PA Amy Suwanabol, MD, Ann Arbor, MI 7:35 am Leveraging the Medical Record and Technology to Screen Surgical Patients for Frailty Joshua Wolf, MD, Baltimore, MD 7:45 am Using Frailty Screening Tools to Predict Functional Recovery in Geriatric Surgical Patients Jennifer Holder-Murray, MD, Pittsburgh, PA 7:55 am How to Define and Manage Social Frailty in our Surgical Patients Julia Berian, MD, MS Madison, WI 8:05 am Utilizing and Modifying Enhanced Recovery Protocols for Geriatric Patients (G-RAS) Hiroko Kunitake, MD, MPH, Boston, MA 8:15 am Geriatrician-Surgeon Collaboration: From Prehabilitation to Co-Management Marcia Russell, MD, Los Angeles, CA 8:25 am Pre-treatment Goal Setting, Shared Decision Making and the Role of Adapted Care for Geriatric Surgical Patients Emily Rivet, MD, Richmond, VA 8:35 am Panel Discussion 9:00 am Adjourn