Keywords
Atrial fibrillation
Elderly
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Abstract
Objective: To synthesize the effectiveness, safety, and adherence to DOACs in elderly individuals with atrial fibrillation in real-world practice, identifying clinical factors such as renal function, frailty, polypharmacy, risk of falls, and interactions associated with better outcomes and appropriate dose use. Methods: This integrative review, developed using PICO strategy criteria, was conducted through searches of the PubMed Central (PMC), CAPES Periodicals, and Virtual Health Library (VHL) databases, using the descriptors "Atrial Fibrillation," "Anticoagulants," and "Aged" in combination with the Boolean term "AND." This search yielded 14,620 articles, and after applying inclusion and exclusion criteria, 20 were selected for this article. Results: DOACs are effective and safe in elderly individuals with atrial fibrillation, with greater adherence and a lower risk of intracranial hemorrhage compared to VKAs. Factors such as renal function, frailty, polypharmacy, risk of falls, and drug interactions directly influence clinical outcomes and dose selection. Individualized treatment is essential to balance efficacy, safety, and adherence in real-world practice. Final considerations: DOACs are effective in elderly patients with atrial fibrillation, especially when tailored to renal function, frailty, polypharmacy, risk of falls, and drug interactions.
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