- Among cognitively healthy community-dwelling older adults, daily low-dose aspirin is not efficacious for dementia or Alzheimer disease (AD) prevention.
Why this matters
- Dementia is increasing in prevalence, has considerable morbidity, and lacks effective treatments.
- Editorial: "Aspirin therapy offers no protective effects for later-life cognition, cardiovascular disease, disability, or death.”
- During median 4.7 years, 3.0% of participants received a dementia diagnosis (41% clinically probable AD).
- No significant difference of aspirin vs placebo on risk (HRs; 95% CIs) for:
- Diagnosed dementia: 0.98 (0.83-1.15).
- Suspected dementia: 1.03 (0.91-1.17).
- Clinically probable AD: 0.96 (0.74-1.24).
- Mild cognitive impairment: 1.12 (0.92-1.37).
- Aspirin and placebo groups had similar small changes in cognitive performance over time.
- US and Australian randomized controlled trial among 19,114 community-dwelling adults age ≥70 years (US minorities, ≥65 years) free of cardiovascular disease, physical disability, diagnosed dementia (ASPREE trial).
- Randomization: double-blind low-dose aspirin (100 mg daily) vs placebo.
- Main outcome: adjudicated diagnosis of dementia according to DSM-IV criteria.
- Funding: US National Institute on Aging; US National Cancer Institute; National Health and Medical Research Council of Australia; others.
- Incidences of dementia, mild cognitive impairment were lower than previously reported.
- Aspirin dose, follow-up duration may have been insufficient.
- Poor adherence by end of study.