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    Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline.

    Access Status
    Open access via publisher
    Authors
    Ryan, Joanne
    Storey, Elsdon
    Murray, Anne M
    Woods, Robyn L
    Wolfe, Rory
    Reid, Christopher
    Nelson, Mark R
    Chong, Trevor TJ
    Williamson, Jeff D
    Ward, Stephanie A
    Lockery, Jessica E
    Orchard, Suzanne G
    Trevaks, Ruth
    Kirpach, Brenda
    Newman, Anne B
    Ernst, Michael E
    McNeil, John J
    Shah, Raj C
    ASPREE Investigator Group
    Date
    2020
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Ryan, J. and Storey, E. and Murray, A.M. and Woods, R.L. and Wolfe, R. and Reid, C.M. and Nelson, M.R. et al. 2020. Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline. Neurology. 95 (3): pp. e320-e331.
    Source Title
    Neurology
    DOI
    10.1212/WNL.0000000000009277
    ISSN
    0028-3878
    Faculty
    Faculty of Health Sciences
    School
    School of Public Health
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1136372
    http://purl.org/au-research/grants/nhmrc/1135727
    http://purl.org/au-research/grants/nhmrc/1127060
    http://purl.org/au-research/grants/nhmrc/334047
    URI
    http://hdl.handle.net/20.500.11937/80070
    Collection
    • Curtin Research Publications
    Abstract

    OBJECTIVE: To determine the effect of low-dose aspirin vs placebo on incident all-cause dementia, incident Alzheimer disease (AD), mild cognitive impairment (MCI), and cognitive decline in older individuals.

    METHODS: Aspirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled trial of low-dose aspirin. In the United States and Australia, community-dwelling individuals aged ≥70 years (US minorities ≥65 years) and free of cardiovascular disease, physical disability, and diagnosed dementia were enrolled. Participants were randomized 1:1-100 mg daily aspirin or placebo. The Modified Mini-Mental State Examination, Hopkins Verbal Learning Test-Revised, Symbol Digit Modalities Test, and Controlled Oral Word Association Test assessed cognition at baseline and over follow-up. Additional cognitive testing was performed in participants with suspected dementia ("trigger") based on within-study assessments or clinical history. Dementia was adjudicated according to DSM-IV criteria. National Institute on Aging-Alzheimer's Association criteria were used for AD and MCI subclassification.

    RESULTS: A total of 19,114 participants were followed over a median 4.7 years and 964 triggered further dementia assessments. There were 575 adjudicated dementia cases, and 41% were classified as clinically probable AD. There was no substantial difference in the risk of all dementia triggers (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.91-1.17), probable AD (HR, 0.96; 95% CI, 0.74-1.24), or MCI (HR, 1.12; 95% CI, 0.92-1.37) between aspirin and placebo. Cognitive change over time was similar in the aspirin and placebo groups.

    CONCLUSIONS: There was no evidence that aspirin was effective in reducing risk of dementia, MCI, or cognitive decline. Follow-up of these outcomes after initial exposure is ongoing. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for healthy older individuals, low-dose aspirin does not significantly reduce the incidence of dementia, probable AD, MCI, or cognitive decline. CLINICALTRIALSGOV IDENTIFIER: NCT01038583.

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