Abstract
As the population ages, increasing numbers of frail older adults are requiring surgery and other interventions. Frail adults face unique risks when undergoing surgical procedures because they have little tolerance for stress and adverse events can have a big impact on their functional status. A recommended model for preoperative assessment and decision making draws on evidence and experience to help predict functional outcomes most relevant to the patient. This model relies on the use of validated risk assessment tools and considers geriatric risks (including delirium), likely functional outcomes, the patient's capacity to consent, and patient goals and values.