There is considerable clinical evidence that the process of anesthesia and surgery independently causes cognitive decline, known as Perioperative Neurocognitive Disorders (PND) (previously known as Postoperative Cognitive Dysfunction (POCD)). This includes postoperative delirium and postoperative neurocognitive disorder (postoperative NCD).  We know that patients with even subtle impairment preoperatively are at increased risk of these disorders.  There is also a large body of laboratory evidence demonstrating an association between anesthetic agents and Alzheimer's disease neuropathology. An increasing number of elderly people are requiring surgery and anesthesia, many of whom will have, or be at risk of, Mild Cognitive Impairment (MCI) or Alzheimer's disease. This PIA seeks to encourage communication and collaboration and combine research expertise, to improve cognitive outcomes and informed choices following these increasingly common procedures in the older adult.