Abstract：
The World Health Organization estimates that the world\'s population over 60 years of age will nearly double in the next 30 years. This change imposes increasing demands on health and social services with increased disease burden in older people, hereafter defined as people aged 60 years or more. An older population will have a greater incidence of cardiovascular disease partly due to higher levels of blood fibrinogen, increased levels of some coagulation factors, and increased platelet activity. These factors lead to a hypercoagulable state which can alter haemostasis, causing an imbalance in appropriate coagulation, which plays a crucial role in the development of cardiovascular diseases. These changes in haemostasis are not only affected by age but also by gender and the effects of hormones, or lack thereof in menopause for older females, ethnicity, other comorbidities, medication interactions, and overall health as we age. Another confounding factor is how we measure fibrinogen and coagulation through laboratory and point-of-care testing and how our decision-making on disease and treatment (including anticoagulation) is managed. It is known throughout life that in normal healthy individuals the levels of fibrinogen and coagulation factors change, however, reference intervals to guide diagnosis and management are based on only two life stages, paediatric, and adult ranges. There are no specific diagnostic guidelines based on reference intervals for an older population. How ageing relates to alterations in haemostasis and the impact of the disease will be discussed in this chapter. Along with the effect of anticoagulation, laboratory testing of fibrinogen and coagulation, future directions, and implications will be presented.
摘要：
世界卫生组织估计，在未来30年内，世界60岁以上的人口将几乎翻一番。这一变化对健康和社会服务提出了越来越高的要求，老年人的疾病负担增加，以下定义为60岁或以上的人。老年人群将有更高的心血管疾病发病率，部分原因是血液纤维蛋白原水平较高，某些凝血因子水平升高，和血小板活性增加。这些因素导致高凝状态，可以改变止血，导致适当的凝血不平衡，在心血管疾病的发展中起着至关重要的作用。止血的这些变化不仅受年龄的影响，还受性别和激素的影响，或老年女性更年期缺乏，种族,其他合并症,药物相互作用,随着年龄的增长和整体健康。另一个混杂因素是我们如何通过实验室和即时检测来测量纤维蛋白原和凝血，以及我们如何管理疾病和治疗（包括抗凝）的决策。众所周知，在正常健康个体中，纤维蛋白原和凝血因子的水平会发生变化，然而,指导诊断和管理的参考间隔仅基于两个生命阶段，儿科,和成人范围。对于老年人群，没有基于参考间隔的具体诊断指南。本章将讨论衰老与止血改变和疾病影响的关系。随着抗凝的作用，纤维蛋白原和凝血的实验室检测，未来的方向,和含义将被提出。
