Inclusion Criteria:  Patients 70 years of age or older, Major gynecologic, abdominal, urologic, thoracic or orthopedic surgery via laparoscopy or laparotomy under general anesthesia - with or without concomitant use of regional or neuraxial anesthesia -, Expected anesthesia time of more than 60 minutes, Seen for assessment by internal medicine and/or anesthesiology at the preoperative clinic (CIEPC)  Exclusion Criteria:  Known diagnosis of dementia or other neurological, psychiatric, developmental or medical condition that resulted in documented severe cognitive impairment, Emergency surgery, Significant auditory or visual impairment that precludes participation in cognitive testing, Known allergy or intolerance or other medical condition that precludes the use of prescribed general anesthesia protocol for this study, Inability to communicate in French or English.