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Aspirin and cognitive decline

Jul 6, 2021

Daily low-dose aspirin does not prevent cognitive decline in healthy older adults



PRESS RELEASE: April 1, 2020

Researchers at Monash University and the Berman Center for Outcomes and Clinical Research in the US, have found that daily aspirin does not reduce the risk of Alzheimer’s disease, mild cognitive impairment, or cognitive decline in older people.

The findings come from an in-depth analysis of cognitive data from 19,114 participants in the ASPREE (ASPirin in Reducing Events in the Elderly) trial recently published online in the Journal of Neurology.

Lead author, A/Professor Joanne Ryan, Head of Biological Neuropsychiatry and Dementia Unit at Monash University, said ASPREE was the first large scale clinical trial that looked at the effect of low-dose aspirin on cognitive loss and specifically, Alzheimer’s disease.

Woman with brown hair, fair skin wearing a red cardigan over a white shirt, stands with her arms crossed and smiling at the camera
Above: A/Prof Joanne Ryan leads the Biological Neuropsychiatry and Dementia Unit, Monash University

“In this paper, we looked at whether the effect of aspirin on thinking and memory differed for specific age-groups, gender, ethnicity and health factors, such as blood pressure and found no evidence of any benefit for any group,” said A/Prof Ryan.

“Aspirin did not reduce the risk of developing Alzheimer’ Disease or delay milder losses of memory and thinking ability.”

ASPREE participants took 100mg aspirin or a matched placebo and underwent regular thinking and memory measures over the average 4.7 year trial. The majority of participants were aged 70 years or more and all were free of cardiovascular disease and dementia at entry into the trial.

By the end of ASPREE, 575 people were diagnosed with dementia. Fewer than half of the cases were Alzheimer ’s disease.

Co-lead author and Neurologist, Professor Elsdon Storey, said the study’s findings were very relevant to the care of healthy older people.

“This paper indicates that aspirin should not be prescribed solely on the basis of potential cognitive benefits, as there is no evidence to suggest this, nor that low-dose aspirin could reduce the risk of Alzheimer’s disease,” said Prof Storey.

A/Prof Ryan added that the cognitive health of ASPREE participants was being tracked in the follow-up ASPREE-XT study, to determine whether benefits of aspirin may become apparent later on.

“Because dementia can take years to develop, it is possible that ASPREE was not a long enough trial to show possible benefits from aspirin, so we will continue to examine for long-lasting effects of aspirin in study participants in the coming years,” said A/Prof Ryan.

The authors pointed out that all ASPREE participants were relatively healthy at the start of the trial, and as such, findings from this paper may not apply to all older adults.  They recommend consulting with doctors for individual health advice before taking or ceasing daily low dose aspirin.

The ASPREE trial was supported by the National Institute on Aging, the National Cancer Institute, within the National Institutes of Health in the US, the Australian National Health and Medical Research Council, Monash University and the Victorian Cancer Agency. Bayer provided the trial drug and placebo but had no other role in this trial.

The follow up ASPREE-XT study is supported by the National Institute on Aging, the National Cancer Institute and the National Institutes of Health in the US and the Australian National Health and Medical Research Council.

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