Postoperative delirium (POD) and longer term postoperative neurocognitve disorders (NCD) are the most common surgical complications in geriatric patients, with POCD affecting ~20% and POD affecting up to 50%. These are also independently associated with increased hospital length of stay, functional disability, and mortality. General anesthesia during surgery is most commonly maintained with inhaled volatile anesthetics (GAS); however, maintenance with total intravenous anesthesia (TIVA) is a technique with potential advantages. Previous preclinical studies have suggested that IV agentshave anti-inflammatory properties, while GAS is pro-inflammatory. The aim of this study is to compare the use of GAS vs. TIVA on POD, NCD, functional status, patient reported outcomes (PROs), and biomarkers in the geriatric population. We hypothesize that TIVA is associated with a lower incidence of neurocognitive and functional decline, as well as improved PROs compared to GAS.