Bariatric Surgery in Elderly

This chapter examines the intricate landscape of bariatric surgery in elderly individuals, exploring diverse aspects from preoperative assessment to postoperative outcomes and ethical considerations. Recognizing the growing prevalence of obesity in the elderly, this chapter focuses on preoperative assessments tailored to this demographic. Age-related physiological changes are examined, elucidating their profound impact on surgical procedures. The choice of bariatric procedure for elderly patients is a critical decision point, and this chapter delves into the considerations for gastric bypass versus sleeve gastrectomy. In addition, pharmacokinetics emerges as a promising avenue for weight loss, with implications for personalized interventions in the elderly population. Postoperative care is a critical aspect of bariatric surgery, particularly in the elderly population. This chapter covers a spectrum of considerations, ranging from cardiovascular and perioperative anesthetic management of pain control, addressing postoperative cognitive dysfunction or delirium, nutritional support, mobility, and psychosocial aspects. Outcomes of bariatric surgery in elderly patients are also evaluated, encompassing weight loss and maintenance, improvements in comorbidities, risk of complications, and comparative analyses between older and younger populations. Ethical considerations form an integral part of the discussion, emphasizing the imperative to balance risks and benefits and combat ageism in the decision-making process. By encapsulating a comprehensive overview of bariatric surgery in the elderly, this chapter serves as a valuable resource for clinicians, researchers, and policymakers navigating the complexities of this dynamic field.