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dc.contributor.authorRyan, Joanne
dc.contributor.authorStorey, Elsdon
dc.contributor.authorMurray, Anne M
dc.contributor.authorWoods, Robyn L
dc.contributor.authorWolfe, Rory
dc.contributor.authorReid, Christopher
dc.contributor.authorNelson, Mark R
dc.contributor.authorChong, Trevor TJ
dc.contributor.authorWilliamson, Jeff D
dc.contributor.authorWard, Stephanie A
dc.contributor.authorLockery, Jessica E
dc.contributor.authorOrchard, Suzanne G
dc.contributor.authorTrevaks, Ruth
dc.contributor.authorKirpach, Brenda
dc.contributor.authorNewman, Anne B
dc.contributor.authorErnst, Michael E
dc.contributor.authorMcNeil, John J
dc.contributor.authorShah, Raj C
dc.contributor.authorASPREE Investigator Group
dc.identifier.citationRyan, 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.

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.

dc.subjectASPREE Investigator Group
dc.titleRandomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline.
dc.typeJournal Article
curtin.departmentSchool of Public Health
curtin.accessStatusFulltext not available
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidReid, Christopher [0000-0001-9173-3944]

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