Using prospectively collected clinical data from the Chinese Perioperative Database of Elderly Patients, this study retrospectively analyzed patients aged ≥65 years who underwent elective non-cardiac, non-neurosurgical procedures under general anesthesia between April 2020 and April 2022. The study examined the associations between various preoperative health and functional status assessment tools and the occurrence of cardiovascular and cerebrovascular complications within 30 days after surgery, aiming to compare the clinical value of different assessment instruments.

Inclusion criteria:

1. Aged ≥65 years;
2. Scheduled for elective non-cardiac, non-neurosurgical procedures;
3. Consented to undergo preoperative functional status and quality of life assessments.

Exclusion criteria:

1. Had severe dementia, language disorders, significant hearing or visual impairments, or were in a coma;
2. Had Mini-Mental State Examination (MMSE) scores below the established educational thresholds: <18 for illiterate individuals, <21 for those with primary education (≤6 years), and <25 for those with secondary education or higher (>6 years);
3. Underwent local anesthesia or monitored anesthesia care;
4. Had an operative time ≤30 minutes;
5. Incompleted all the designated functional status and quality of life assessments.

Patients were interviewed one day before surgery and completed a comprehensive preoperative functional status and quality of life assessment, which included the Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), EuroQol Five-Dimension Five-Level (EQ-5D-5L), Metabolic Equivalent of Task (MET), and FRAIL scale.