Aspirin and dementia

Aspirin and dementia risk

• aspirin and primary cardiovascular disease prevention
  • primary cardiovascular disease prevention, daily low-dose aspirin has been shown to cause an 11% proportional decrease in the risk of major vascular events (including a 19% reduction in ischaemic strokes) but a 43% proportional increase in the risk of serious bleeding (1)
    
    
• the ASCEND trial, 15,480 people from the UK with diabetes and no history of cardiovascular disease were randomized to aspirin 100 mg daily or matching placebo for a mean of 7.4 years. The 15,427 ASCEND participants with no recorded dementia prior to baseline were included in this cognitive study with a primary pre-specified outcome of 'broad dementia', comprising dementia, cognitive impairment, or confusion
  • analysis of the ASCEND trial in adults with diabetes and no history of CVD (n=15,427) found no statistically significant benefit for aspirin 100mg daily on development of dementia, cognitive impairment, or confusion (7.8% v 7.1% placebo, rate ratio 0.91 [95% CI 0.81-1.02]

Reference:

• Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and meta-analysis. JAMA 2019; 321:277-287.
• Parish S et al. ASCEND Study Collaborative Group, Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial, European Heart Journal, 2022;, ehac179, https://doi.org/10.1093/eurheartj/ehac179