ArticleJournal of the American Geriatrics Society2020
Geriatric Elements and Oral Anticoagulant Prescribing in Older Atrial Fibrillation Patients: SAGE-AF.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
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Who cites it
51 citing papers in PubMed.
- Variability in Nonvitamin K Oral Anticoagulant Dose Eligibility and Adjustment According to Renal Formulae and Clinical Outcomes in Patients With Atrial Fibrillation With and Without Chronic Kidney Disease: Insights From ORBIT-AF II.Journal of the American Heart Association · 2023Trial
- Recurrence or persistence of atrial fibrillation is associated with frailty and adverse outcomes: the SAGE-AF cohort study.BMC geriatrics · 2026Article
- Fazekas score predicts cognitive decline & frailty in older adults: insights from the SAGE-AF cohort study.Neurological research and practice · 2025Article
- Predicting survival in atrial fibrillation: results from SAGE-AF.Journal of geriatric cardiology : JGC · 2025Article
- Cognitive impairment and treatment strategy for atrial fibrillation in older adults: The SAGE-AF study.Journal of the American Geriatrics Society · 2024Observational
- Atrial fibrillation: comorbidities, lifestyle, and patient factors.The Lancet regional health. Europe · 2024Review
- Utilization of P2YThe American journal of cardiology · 2023Article
- Preexisting anticoagulation is an independent predictor of mortality in geriatric trauma patients - a retrospective cohort study.Annals of medicine and surgery (2012) · 2023Article
- ABCs: A Better Chance to Improve Outcomes in Atrial Fibrillation.JACC. Asia · 2023Article
- Factors associated with oral anticoagulant prescription status among patients with a new diagnosis of atrial fibrillation.Clinical cardiology · 2023Article
- Retrospective Cross-sectional Analysis of Older Adults Living with Frailty and Anticoagulant Use for Atrial Fibrillation.Canadian geriatrics journal : CGJ · 2023Article
- Frailty and Cardiovascular Mortality: A Narrative Review.Current cardiology reports · 2023Review
- Is catheter ablation associated with preservation of cognitive function? An analysis from the SAGE-AF observational cohort study.Frontiers in neurology · 2023Article
- The role of prognostic stratification on prescription of anticoagulants in older patients with atrial fibrillation: a multicenter, observational, prospective European study (EUROSAF).Annals of medicine · 2022Observational
- Presence of Geriatric Conditions Is Prognostic of Major Bleeding in Older Patients with Atrial Fibrillation: a Cohort Study.Journal of general internal medicine · 2022Article
- Usefulness of Self-Reported Physical Activity and Clinical Outcomes in Older Patients With Atrial Fibrillation.The American journal of cardiology · 2022Article
- Perception of atrial fibrillation symptoms: Impact on quality of life and treatment in older adults.Journal of the American Geriatrics Society · 2022Article
- Cognitive impairment, age, quality of life, and treatment strategy for atrial fibrillation in older adults: The SAGE-AF study.Journal of the American Geriatrics Society · 2022Article
- Influence of atrial fibrillation subtypes on anticoagulant therapy in a high-risk older population: the FAI project.Aging clinical and experimental research · 2022Article
- Online health information seeking, low atrial fibrillation-related quality of life, and high perceived efficacy in patient-physician interactions in older adults with atrial fibrillation.Cardiovascular digital health journal · 2022Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectivesOral anticoagulants are the cornerstone of stroke prevention in high-risk patients with atrial fibrillation (AF). Geriatric elements, such as cognitive impairment and frailty, commonly occur in these patients and are often cited as reasons for not prescribing oral anticoagulants. We sought to systematically assess geriatric impairments in patients with AF and determine whether they were associated with oral anticoagulant prescribing.
designCross-sectional analysis of baseline data from the ongoing Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) prospective cohort study.
settingMulticenter study with site locations in Massachusetts and Georgia that recruited participants from cardiology, electrophysiology, and primary care clinics from 2016 to 2018.
participantsParticipants with AF age 65 years or older, CHA MEASUREMENTS: A six-component geriatric assessment included validated measures of frailty, cognitive function, social support, depressive symptoms, vision, and hearing. Oral anticoagulant use was abstracted from the medical record.
resultsA total of 1244 participants (mean age = 76 y; 49% female; 85% white) were enrolled; 42% were cognitively impaired, 14% frail, 53% pre-frail, 12% socially isolated, and 29% had depressive symptoms. Oral anticoagulants were prescribed to 86% of the cohort. Oral anticoagulant prescribing did not vary according to any of the geriatric elements (adjusted odds ratios [ORs] for oral anticoagulant prescribing and cognitive impairment: OR = .75; 95% confidence interval [CI] = .51-1.09; frail OR = .69; 95% CI = .35-1.36; social isolation OR = .90; 95% CI = .52-1.54; depression OR = .79; 95% CI = .49-1.27; visual impairment OR = .98; 95% CI = .65-1.48; and hearing impairment OR = 1.05; 95% CI = .71-1.54).
conclusionGeriatric impairments, particularly cognitive impairment and frailty, were common in our cohort, but treatment with oral anticoagulants did not differ by impairment status. These geriatric impairments are commonly cited as reasons for not prescribing oral anticoagulants, suggesting that prescribers may either be unaware or deliberately ignoring the presence of these factors in clinical settings. J Am Geriatr Soc 68:147-154, 2019.
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