Table 1_Efficacy of anticoagulation therapy in elderly patients with clinically diagnosed Alzheimer’s disease and atrial fibrillation: a clinical outcomes study.docx

DOACs were superior to warfarin in preventing stroke/embolism (HR = 0.36, 95% CI 0.15–0.87, p = 0.022). While major bleeding was higher with anticoagulation (6.1% vs. 0.9%; HR = 4.31, 95% CI 1.02–18.19, p = 0.047), the critical risk of intracranial hemorrhage was not significantly increased (1.6% vs. 1.0%; HR = 0.46, 95% CI 0.11–1.98, p = 0.30), and DOACs demonstrated a safer profile versus warfarin for major bleeding (HR = 0.24, 95% CI 0.06–0.89, p = 0.034).

Key predictors for bleeding and thromboembolism, for example, advanced age, previous stroke history, and high HAS-BLED scores, were identified.</p>Discussion<p>In conclusion, anticoagulation, particularly with DOACs, provides a favorable net clinical benefit by significantly reducing stroke and mortality without a marked increase in intracranial hemorrhage in elderly AD patients with AF, supporting its judicious use. Further prospective studies are warranted to refine personalized decision-making.</p>Systematic review registration<p>crd.york.ac.uk/PROSPERO/view/CRD420251271276, Identifier: CRD420251271276.</p>