The risk for both arterial and venous thrombosis increases with age. Despite the increasing
burden of strokes related to atrial fibrillation (AF) and venous thromboembolism (VTE)
among older adults, the use of anticoagulant therapy is limited in this population
due to the parallel increase in risk of serious hemorrhage. Understanding the risks
and their underlying mechanisms would help to mitigate adverse events and improve
persistence with these life-saving therapies. The objectives of this review are to:
(1) elucidate the age-related physiologic changes that render this high risk subgroup
susceptible to hemorrhage, (2) identify mutable risk factors and hazards contributing
to an increased bleeding risk in older individuals, and (3) discuss interventions
to optimize anticoagulation therapy in this population.
Keywords
aging - anticoagulation - warfarin - atrial fibrillation - stroke - venous thromboembolism