The score is a reasonable prediction of one's risk, whether due to a comorbidity or simply due to aging, since those are strong co-factors in those who historically have more strokes. The decision to actually take a prophylactic against strokes is a decision shared between the patient and the physician assigning the risk. At some point, though, if I were a physician some of whose patients, well aged, were still taking a DOAC, I would counsel them to consider the risk of bleeding to death from something like a hip fracture, which a DOAC will exacerbate. Hip factors and heart attacks are also common among the aged, as are cancers.

I agree with you, and you are most likely correct in your assessment of big-pharma. I am 85 and am now in AF which was detected during prep for cataract surgery. I have been in AF since 27 Dec and am on Eliquis 2 times a day. Is this my 1st bout of AF? Who knows. I am asymptomatic other than the pulse rate. I may have had AF before, but until this diagnosis I have never taken anticoagulants.
The CHA2DS2-VASc score metrics are like all things that have age as a discriminator. At 74 you have a score of 0, but at 75 you are a +2. Wow, what a difference a day makes.