Effect of aspirin on healthspan in community-dwelling older adults: the ASPirin in reducing events in the elderly study.

BACKGROUND

Inflammation is a shared pathogenic pathway underlying multiple chronic conditions and contributes to a loss of healthspan. This study aimed to evaluate the effect of low-dose aspirin on the loss of healthspan in older individuals.

METHODS

ASPirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled, randomised trial assessing the effect of daily low-dose aspirin for primary prevention. Community-dwelling participants aged ≥70 years [or ≥ 65 years for United States (US) minority ethnic groups] were recruited from Australia and the US. Eligible participants were initially free of major diseases with a life expectancy of more than five years and were randomly assigned to receive 100 mg of aspirin daily or a placebo. Loss of healthspan was defined as the first occurrence of cardiovascular disease, diabetes, dementia, cancer, or death.

RESULTS

A total of 19 114 participants were followed for a median of 4.7 years, 5835 participants (30.5%) experienced a loss of healthspan. Participants who were older, male, smokers, or had hypertension, or frailty were more likely to experience healthspan loss during the trial. The rate of healthspan loss was 82.1 and 82.7 events per 1000 person-years in the aspirin and placebo groups, respectively. There was no evidence of a substantial difference in the risk of healthspan loss between the aspirin and placebo groups (hazard ratio, 0.98; 95% CI: 0.92-1.05).

CONCLUSION

Low-dose aspirin had no effect on the rate of loss of healthspan among older community-dwelling adults. Future studies should explore lifestyle and behavioural interventions to extend healthspan.