Frailty and Muscle Strength Tests in Older Adults Undergoing Major Surgery

"Participants will undergo a structured frailty and muscle-strength assessment battery performed during their routine preoperative evaluation. These assessments serve as the primary exposure measures of interest and include:~Clinical Frailty Scale (CFS) evaluation (functional frailty assessment) Respiratory muscle strength assessment (Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) using a MicroRPM handheld respiratory pressure meter) Hand-grip strength measurement (using Jamar dynamometer) Physical performance evaluation (Timed Up-and-Go (TUG) test) Skeletal muscle mass estimation (Bioelectrical impedance analysis, InBody 120) Muscle thickness measurement (Rectus femoris muscle thickness using portable ultrasound) Cognitive function screening (Mini-Cog test) Nutritional risk screening (Perioperative Nutrition Screen \[PONS\]) No additional interventions beyond these observational assessments will be conducted."