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Evidence Summary

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Low-dose aspirin does not reduce cognitive impairment in older adults

Veronese N, Stubbs B, Maggi S, et al. Low-Dose Aspirin Use and Cognitive Function in Older Age: A Systematic Review and Meta-analysis. J Am Geriatr Soc. 2017;65:1763-8.

Review question

In older adults who do not have cognitive impairment or dementia, does low-dose aspirin slow cognitive impairment?

Background

As people age, it is natural for memory to get worse. Mild cognitive impairment can include problems with thinking, memory, language, and judgment that are noticeable. Dementia is more serious cognitive impairment that interferes with daily living. Many people use low-dose aspirin to prevent cardiovascular diseases. Since cardiovascular diseases are risk factors for cognitive impairment and dementia, it is possible that aspirin might prevent or slow worsening of cognitive function.

How the review was done

The researchers did a systematic review, searching for studies that were published up to September 2016. They found 3 randomized controlled trials with 10,037 people who were, on average, 67 years of age. 74% were women. People were followed for 3 to 10 years.

The key features of the studies were as follows:

  • people in the trials did not have cognitive impairment or dementia;
  • treatment was low-dose aspirin, less than 300 mg/day;
  • low-dose aspirin was compared with placebo or no aspirin for at least 1 year; and
  • the outcome was cognitive function.

What the researchers found

The quality of the trials was good.

People who took aspirin did not differ from those who did not for global cognitive test scores and verbal memory scores.

Low-dose aspirin improved executive function (ability to manage time, pay attention, switch focus) and fluency (ability to speak accurately and quickly) test scores.

More people who used low-dose aspirin had stomach-related adverse effects.

Conclusion

In people who do not have cognitive impairment or dementia, taking low-dose aspirin does not reduce cognitive impairment.

Low-dose aspirin vs placebo or no aspirin in people who do not have cognitive impairment or dementia

Outcomes

Effect of low-dose aspirin

Global cognitive test scores

No differences between groups.

Verbal memory tests

No differences between groups.

Executive function and fluency tests

Low-dose aspirin improved scores.

Adverse effects

Low-dose aspirin increased stomach-related side-effects.

 




Glossary

Cognitive function
Mental processes, including thinking, learning and remembering.
Cognitive impairment
Trouble remembering, learning new things, concentrating, or making decisions that affect everyday life.
Placebo
A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk factors
Aspects making a condition more likely.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
Vascular
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

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