ArticleJournal of the American Geriatrics Society2023
Differential effect of anticoagulation according to cognitive function and frailty in older patients with atrial fibrillation.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Oral Anticoagulant Use Among Residents in VA Long-Term Care With Atrial Fibrillation After the 2014 ACC/AHA Guideline.Journal of the American Medical Directors Association · 2026Observational
- Navigating Anticoagulation Decisions in Atrial Fibrillation and Frailty Comorbidity.Life (Basel, Switzerland) · 2026Review
- Article
- Comparison of Safety and Effectiveness Between Direct Oral Anticoagulants and Vitamin K Antagonists in Dementia Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Frailty Matters-Why Isn't It Guiding Clinical Decisions?Journal of the American Geriatrics Society · 2025Article
- Impact of frailty on outcomes of elderly patients with atrial fibrillation: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- Complexities in Geriatric Cardiology: Clinical Dilemmas and Gaps in Evidence.Journal of geriatric cardiology : JGC · 2025Article
- Association of cardiovascular diseases with cognitive performance in older adults.American heart journal · 2024Article
- Utilization of P2YThe American journal of cardiology · 2023Article
- Initiation of oral anticoagulation in US older adults newly diagnosed with atrial fibrillation during hospitalization.Journal of the American Geriatrics Society · 2023Article
- Clinical benefits of oral anticoagulants in atrial fibrillation patients with dementia: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2023Review
- Anticoagulation Patterns Among Community-Dwelling Older Adults With Atrial Fibrillation.Journal of primary care & community healthArticle
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundIn older patients with atrial fibrillation (AF), cognitive impairment and frailty are prevalent. It is unknown whether the risk and benefit of anticoagulation differ by cognitive function and frailty.
methodsA total of 1244 individuals with AF with age ≥65 years and a CHADSVASC score ≥2 were recruited from clinics in Massachusetts and Georgia between 2016 and 18 and followed until 2020. At baseline, frailty status and cognitive function were assessed. Hazard ratios of anticoagulation on physician adjudicated outcomes were adjusted by the propensity for receiving anticoagulation and stratified by cognitive function and frailty status.
resultsThe average age was 75.5 (± 7.1) years, 49% were women, and 86% were prescribed oral anticoagulants. At baseline, 528 (42.4%) participants were cognitively impaired and 172 (13.8%) were frail. The adjusted hazard ratios of anticoagulation for the composite of major bleeding or death were 2.23 (95% confidence interval: 1.08-4.61) among cognitively impaired individuals and 0.94 (95% confidence interval: 0.49-1.79) among cognitively intact individuals (P for interaction = 0.08). Adjusted hazard ratios for anticoagulation were 1.84 (95% confidence interval: 0.66-5.13) among frail individuals and 1.39 (95% confidence interval: 0.84-2.40) among not frail individuals (P for interaction = 0.67).
conclusionCompared with no anticoagulation, anticoagulation is associated with more major bleeding episodes and death in older patients with AF who are cognitively impaired.
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