The increasing number of elderly patients undergoing surgery is due both to the expanding elderly population and to important recent advances in surgical and anesthetic techniques. As the population ages, there are increasing numbers of individuals with chronic diseases benefiting from surgical intervention such as cataracts, prostatic hypertrophy, colorectal cancer, joint degeneration, and peripheral vascular disease.1 Falls, and osteoporosis predispose older persons to fractures of the femoral neck that often require surgical repair. It has been estimated that half the population of older Americans will have an operation after age 65.2 The introduction of neuroleptic anesthesia, effective prophylaxis against deep venous thrombosis, and sophisticated perioperative monitoring technology have contributed to lower surgical mortality for older adults.3 In the last few decades, economic pressures and technological advances have resulted in more ambulatory and endoscopie surgery. Returning patients quickly to their usual environment and functional status can reduce complications so commonly related to medications and immobilization associated with hospitalization. Important outcomes such as reduced morbidity and mortality, shorter hospital stays, and more rapid return to usual preoperative activities have all been reported with laparoscopic cholecystectomy compared with open cholecystectomy in older persons.4 The lowered risk of operative morbidity and mortality has encouraged physicians and patients to consider surgical therapy more readily.