Prevalence and treatment of atrial fibrillation in older adults

Jacek Liczko1, Samuel Schülein2, Thomas Tümena3

  • 1Geriatrics Center Erlangen, Department of Geriatrics and Geriatric Rehabilitation, Malteser Waldkrankenhaus St. Marien, Rathsberger Straße 57, 91054, Erlangen, Germany. jacekliczko@gmail.com.

Insights

Atrial fibrillation (AF) is common in older adults. Anticoagulation increased significantly, with personalized treatment recommended despite bleeding risks.

Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Public Health

Background:

  • Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the geriatric population, significantly impacting morbidity and mortality.
  • Older adults represent a growing demographic with a high burden of cardiovascular diseases.

Purpose of the Study:

  • To investigate the prevalence, treatment patterns, and comorbidities of AF in a large cohort of hospitalized older adults.
  • To analyze trends in anticoagulation use for AF in this population over a nine-year period.

Main Methods:

  • Retrospective analysis of 10,700 older adults with AF hospitalized between 2010 and 2018.
  • Examination of anticoagulation frequency, comorbidities, and CHA2DS2-VASc scores.
  • Logistic regression to identify predictive factors for anticoagulation.

Main Results:

  • AF prevalence in hospitalized older adults was 29.8% in 2018, with a mean age of 83.2 years.
  • Anticoagulation frequency for AF patients increased from 32.1% (2010) to 64.2% (2018), with a preference for direct oral anticoagulants (DOACs).
  • No predictive factors for anticoagulation were identified in multivariate analysis; non-anticoagulated patients had more diagnoses and poorer functional status.

Conclusions:

  • Hospitalized older adults exhibit a higher prevalence of AF than the general population.
  • Despite increased bleeding risks, anticoagulation use in older adults with AF has risen, with personalized treatment decisions being crucial.
  • The study underscores the need for individualized anticoagulation strategies in older adults, considering their complex health profiles.
Abstract

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