Cerebrovascular prophylaxis of the frail elderly in the rehabilitation setting: a challenge for the geriatrician

The prophylaxis of thromboembolic events plays an important part of the patient’s treatment of atrial fibrillation and is also an important reason for treatment of patients who have experienced a stroke with disabling outcomes. Anticoagulant treatment has both benefits and risks for elderly patients. Benefits include the prevention of ischemic and thromboembolic events and this action is important in a rehabilitation setting, where the patient arrives with motor deficits and periods of variable duration to be spent between the bed and the rehabilitation sessions. The choice to undertake an anticoagulant treatment in rehabilitation setting appears crucial because the adverse events due to both the therapy and the patient’s status (frailty, tendency to fall) can undermine the success of the rehabilitation itself or be at least potentially due to new exacerbations.