Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia.

ABSTRACT:

Background

Approximately 20% of older persons with dementia have atrial fibrillation (AF). Nearly all have stroke risks that exceed the guideline-recommended threshold for anticoagulation. Although individuals with dementia develop profound impairments and die from the disease, little evidence exists to guide anticoagulant discontinuation, and almost one-third of nursing home residents with advanced dementia and AF remain anticoagulated in the last 6 months of life. We aimed to quantify the benefits and harms of anticoagulation in this population.

Methods

Using Minimum Data Set and Medicare claims, we conducted a retrospective cohort study with 14,877 long-stay nursing home residents aged ≥66 between 2013 and 2018 who had advanced dementia and AF. We excluded individuals wit

SUBMITTER: Ouellet GM 

PROVIDER: S-EPMC9957933 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature