A study has found that a lower proportion of people with dementia receive oral anticoagulation compared with people without dementia. People with dementia in the study had a higher bleeding risk and poorer anticoagulation control when treated with warfarin.
The study found that differences in management and outcomes of oral anticoagulant (OAC) use may exist for people with and without dementia or cognitive impairment (CI). The study set out to systematically review the prevalence and safety and effectiveness outcomes of OAC use in people with and without dementia or CI. MEDLINE, EMBASE, and CINAHL databases were searched for studies reporting prevalence or safety and effectiveness outcomes of OAC use for people with and without dementia, published between 2000 to September 2017.
The results of the study found that people with dementia had 52% lower odds of receiving OAC compared to people without dementia. Mean OAC prevalence was 32% for people with dementia, compared to 48% without dementia. There was no difference in the composite outcome of embolic events, myocardial infarction, and all-cause death between dementia and non-dementia groups . Bleeding rate was lower for people without dementia.
Adverse warfarin events were more common for residents of long-term care with dementia. Community-dwelling people with dementia treated with warfarin had poorer anticoagulation control than those without dementia.