# The Use of Direct Oral Anticoagulants (DOACs) in the Geriatric Population—How to Overcome the Challenges of Geriatric Syndromes

## TL;DR

This paper reviews how to use direct oral anticoagulants in elderly patients, addressing challenges like falls and cognitive issues.

## Contribution

The paper provides practical guidance for managing DOACs in geriatric patients with syndromes like cognitive decline and swallowing disorders.

## Key findings

- DOACs can be used in geriatric patients but require special considerations due to geriatric syndromes.
- Practical steps are outlined to manage risks like falls and polypharmacy in elderly patients.
- Data is provided to guide anticoagulant choice and dosing in this population.

## Abstract

Because the number of elderly people is increasing worldwide, and the prevalence of cardiovascular risk factors and cardiovascular diseases increase with age, in current clinical practice we are faced with a large number of geriatric patients requiring oral anticoagulant treatment. Our review highlights some of the particularities of using direct oral anticoagulants (DOACs) in the geriatric population. We focused on the difficulties of managing DOAC treatment in the presence of geriatric syndromes. We highlighted the practical steps needed to overcome the challenges related to the risk of falling, cognitive impairment, swallowing disorders, and polypragmasy to improve patient care. We provided data to help guide the choice of anticoagulant and dose.