Atrial fibrillation: stroke prevention in older adults

Atrial fibrillation (AF) is an increasingly prevalent disease in the elderly. Patients with AF are at increased risk of ischemic stroke, resulting in significant morbidity and mortality. Warfarin is highly effective at reducing stroke risk, with a net clinical benefit favoring treatment in older individuals. The advent of newer oral anticoagulants provides promising alternatives to warfarin. Appropriate risk stratification for stroke should be performed for all patients with AF to guide antithrombotic therapy. For patients at lower stroke risk, bleeding risk stratification tools can also be used when the benefit of anticoagulant therapy is unclear.