I think regardless of age, if a cat has a less than normally calm disposition (which, lets face it, is 95% of cat kingdom) we owners are going to worry!
I was very worried about my little guy when moving because he was such a baby about riding in his crate whenever we went to my parents (about as long a drive as a plane ride), is skittish around a lot of noise and people, and just starts crying nonstop. Hes only 2.5, but the thought of giving him up to the mercies of airline staff definitely made me worry. However, like having to go through surgery, there was only one way to do this and so on the plane he went.
Honestly - definitely get one of those wee wee pads (in my experience I recommend dryfur because they don't shift and absorb odors and wet - important for a boy cat who showed his crate displeasure in that way!), attach a water bowl to the front, put in a small blankie so they don't get too hot, tape a serving of food to the top of the crate in case of problems, maybe add something small that smells like you, and take a deep breath.
Mine came through just fine - he was shaking, crying, and hiding in the corner of his crate when we checked in, but was up and looking around and curious when we collected him on the other side. The dark and engine humming in the hold ought to put the cat asleep. I would also suggest speaking with the airline personnel to ensure the cat is loaded on, the hold is heated and pressurized, and everyone knows your baby is on and taken care of.
I did draw the line at a connection because that's where plenty of mishaps happen, and I didn't want to stress them more than necessary. What about booking an airport shuttle maybe? Is there a pet transport company in your area?