As the proportion of older people in the population increases so too will the prevalence of age-related diseases, many of which are amenable to surgery. This will result in higher numbers of older people considering and undergoing surgical treatment. However, syndromes such as frailty, multimorbidity and functional dependenc render this cohort prone to adverse postoperative outcomes. Identifying frailty early can facilitate timely shared decision making, resource planning and optimization of health to improve outcomes.