Low-Dose Aspirin Use and Cognitive Function in Older Age: A Systematic Review and Meta-analysis

Authors

  • Nicola Veronese MD,

    Corresponding author
    1. Institute for Clinical Research and Education in Medicine, Padova, Italy
    2. Aging Section, Institute of Neurosciences, Italian Research Council, Padova, Italy
    • Address correspondence to: Nicola Veronese, Aging Section, Institute of Neurosciences, Italian Research Council, Padova, Italy, Via Giustiniani, 2—35128 Padova, Italy. E-mail: ilmannato@gmail.com

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    • Joint first authors
  • Brendon Stubbs PhD,

    1. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
    2. South London and Maudsley National Health Service Foundation Trust, London, UK
    3. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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    • Joint first authors
  • Stefania Maggi MD,

    1. Aging Section, Institute of Neurosciences, Italian Research Council, Padova, Italy
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  • Trevor Thompson PhD,

    1. Faculty of Education and Health, University of Greenwich, London, UK
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  • Patricia Schofield PhD,

    1. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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  • Christoph Muller MD,

    1. South London and Maudsley National Health Service Foundation Trust, London, UK
    2. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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  • Ping-Tao Tseng MD,

    1. Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan
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  • Pao-Yen Lin MD,

    1. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
    2. Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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  • André F. Carvalho MD,

    1. Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil
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  • Marco Solmi MD

    1. Institute for Clinical Research and Education in Medicine, Padova, Italy
    2. Department of Neuroscience, University of Padova, Padova, Italy
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Abstract

Objectives

To investigate whether low-dose aspirin (<300 mg/d) can influence the onset of cognitive impairment or dementia in observational studies and improve cognitive test scores in randomized controlled trials (RCTs) in participants without dementia.

Design

Systematic review and meta-analysis.

Setting

Observational and interventional studies.

Participants

Individuals with no dementia or cognitive impairment initially.

Measurements

Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for the maximum number of covariates from each study, were used to summarize data on the incidence of dementia and cognitive impairment in observational studies. Standardized mean differences (SMDs) were used for cognitive test scores in RCTs.

Results

Of 2,341 potentially eligible articles, eight studies were included and provided data for 36,196 participants without dementia or cognitive impairment at baseline (mean age 66, 63% female). After adjusting for a median of three potential confounders over a median follow-up period of 6 years, chronic use of low-dose aspirin was not associated with onset of dementia or cognitive impairment (5 studies, N = 26,159; OR = 0.82, 95% CI = 0.55–1.22, P = .33, I2 = 67%). In three RCTs (N = 10,037; median follow-up 5 years), the use of low-dose aspirin was not associated with significantly better global cognition (SMD=0.005, 95% CI=–0.04–0.05, P = .84, I2 = 0%) in individuals without dementia. Adherence was lower in participants taking aspirin than in controls, and the incidence of adverse events was higher.

Conclusion

This review found no evidence that low-dose aspirin buffers against cognitive decline or dementia or improves cognitive test scores in RCTs.

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