{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T22:47:18Z","timestamp":1754261238477,"version":"3.37.3"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,26]],"date-time":"2018-09-26T00:00:00Z","timestamp":1537920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Evidence on antithrombotic therapy use in centenarians diagnosed with atrial fibrillation (AF) is sparse. Our objective was to investigate a possible underprescribing in centenarians relative to younger cohorts of the oldest\u2010old. We assumed lower AF rates; and, within AF patients, lower use of anticoagulants in those who died as centenarians (aged \u2265100\u2009years) than in those who died aged in their 80s (\u226580\u2009years) or 90s (\u226590\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study was a quarterly structured cohort study over the 6\u2009years before death using administrative data from German institutionalized and non\u2010institutionalized insured patients (whole sample <jats:italic>n<\/jats:italic> =\u20091398 and subsample of AF patients <jats:italic>n<\/jats:italic> =\u2009401 subclassified according to age\u2010of\u2010death groups [\u226580, \u226590, \u2265100\u2009years]). AF, medication, stroke risk (Congestive heart failure; Hypertension; 2 \u00d7 Age \u226575 years; Diabetes mellitus; 2 \u00d7 Stroke; Vascular disease; Age 65\u201374 years; Sex [female] (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc)) and risk of major bleeding (Hypertension; Abnormal renal and liver function; Stroke; Bleeding; Labile International Normalized Ratio [omitted in the present analysis]; Elderly; Drugs or alcohol (HAS\u2010BLED)) were calculated. Generalized estimation equations were used to model the trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Half a year before death (T1), AF rates were higher in patients aged \u226580\u2009years (31.8%) and \u226590\u2009years (30.6%) compared with patients aged \u2265100\u2009years (22.4%), whereas there were no significant differences between age groups 6\u2009years before death (T0). Of all AF patients with AF at T1, 26.7% received anticoagulants; 11.2% vitamin\u2009K antagonists; 15.7% non\u2010vitamin\u2009K antagonist oral anticoagulants; and 17.5% platelet inhibitors; yet 58.1% received none of these drugs. Centenarians received significantly fewer anticoagulants compared with the other age groups. Prescriptions of anticoagulants were not associated with CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc with and without adjustment for HAS\u2010BLED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present findings highlight the need for more appropriate use of anticoagulation therapy in older patients, as well as for new treatment guidelines taking the heterogeneity of very old patients into account. <jats:bold>Geriatr Gerontol Int 2018; 18: 1634\u20131640<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13531","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T02:38:17Z","timestamp":1538015897000},"page":"1634-1640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Atrial fibrillation and medication treatment among centenarians: Are all very old patients treated the same?"],"prefix":"10.1111","volume":"18","author":[{"given":"Reinhold","family":"Kreutz","sequence":"first","affiliation":[{"name":"Institute of Clinical Pharmacology and Toxicology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Insa M","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacology and Toxicology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"Dr\u00e4ger","sequence":"additional","affiliation":[{"name":"Institute of Medical Sociology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franca","family":"Br\u00fcggen","sequence":"additional","affiliation":[{"name":"Institute of Medical Sociology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"H\u00f6rter","sequence":"additional","affiliation":[{"name":"Institute for Health Care Research of the Knappschaft  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Zwillich","sequence":"additional","affiliation":[{"name":"Institute for Health Care Research of the Knappschaft  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelheid","family":"Kuhlmey","sequence":"additional","affiliation":[{"name":"Institute of Medical Sociology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7492-7210","authenticated-orcid":false,"given":"Paul","family":"Gellert","sequence":"additional","affiliation":[{"name":"Institute of Medical Sociology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin 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