Appropriate Anticoagulation Management for Older Adults Living with Dementia

Anticoagulation and/or antiplatelet medication is recommended for individuals who have a history of atrial fibrillation, venous thromboembolism, acute coronary event or are post percutaneous coronary intervention. The purpose of this study was to describe the use of anticoagulants and antiplatelets among older adults living with dementia at hospital admission and 1 month follow up, treatments prescribed and associated complications. The sample included 404 hospitalized older adults living with dementia, the majority of whom were White females, mean age of 82 (SD=8). On admission 69% of the patients were on at least one anticoagulant or antiplatelet medication and at 1 month post discharge this decreased to 64%. At 1 month post discharge the percentage of individuals on two or more anticoagulants decreased from admission 34% to 14%. On admission 11 (4%) patients were admitted with adverse events from anticoagulation and at 1 month post discharge 5(2%) patients readmitted due to adverse events from anticoagulation. Given the risks and benefits of anticoagulation use among older adults living with dementia, a shared decision-making approach with patients and caregivers is recommended. This approach is the best way to help patients achieve their individual goals of care.