Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.

Objective To compare the value of two‐dimensional shear wave elastography (2D‐SWE) and real‐time tissue elastography (RTE) in the assessment of liver fibrosis in patients with chronic liver disease. Methods One hundred and ten patients with chronic liver disease scheduled for liver biopsy were studied. Both 2D‐SWE and RTE were performed on these patients in a same day. The correlation coefficient of liver fibrosis level, receiver operating characteristic (ROC) curve of S≥2, and S=4 of 2D‐SWE and RTE were compared according to pathologic results. Results The correlation coefficient of liver fibrosis level for 2D‐SWE ( r =0 7.76, 95% CI 0 6.83 -0 8.45, P =0.000) was higher than that of RTE ( r =0 5.61, 95% CI 0 4.07-0 6.84, P =0.000)( Z =2 9.3, P =0.003). The area under ROC curve for S≥2 and S=4 of 2D‐SWE were 0 8.66 and 0 9.57 respectively, RTE were 0 7.50 and 0 8.43 respectively, which indicated that 2D‐SWE was better than RTE. Conclusions The diagnostic performance of 2D‐SWE was better than RTE for the assessment of liver fibrosis and cirrhosis.