One of the world’s most widely used drugs could reduce dementia risk – but there’s a catch: ScienceAlert
One of the world’s most widely used drugs could help reduce the risk of dementia if taken daily – but only for some.
An analysis of a large randomized controlled trial, including more than 13,500 older people in Australia and the United States, found that daily aspirin intake is associated with a lower relative risk of dementia in people with certain genes.
The study, published in Alzheimer’s and dementiauses data from one of the largest placebo-controlled trials of aspirin use in healthy older adults.
This is the first study to identify a genetic subgroup of individuals who may reduce their risk of dementia with low doses of aspirin.
The participants who appear to benefit the most are those whose genetic scores are associated with higher platelet counts in their blood.
Among this subgroup, those who took aspirin had a 70% lower risk of developing dementia during the trial compared to those who took a placebo, with the difference appearing after about 2 to 3 years of follow-up.
But there were also risks. Serious bleeding during this period was also about twice as common among people taking aspirin.
“Based on this study, people should not start taking aspirin to prevent dementia without consulting their doctor, particularly given the increased risk of serious bleeding,” warns lead author and public health researcher Peter Fransquet of Monash University.
“We now need to confirm the results in other studies and ultimately test them in a trial designed specifically for people with this genetic profile.”
But if these results hold true, the possibilities are exciting.
“If this persists, the fact that aspirin is already cheap and widely available could make personalized dementia prevention a real possibility,” adds Fransquet.
Today, aspirin is not recommended to prevent cognitive decline.
There is not yet sufficient evidence to suggest that this medicine can reduce the risk of dementia.
But maybe that’s because we lumped everyone together, regardless of their genetic profile.
“Previous trials showed that aspirin did not prevent dementia when everyone was considered together,” says Fransquet.
“Our results suggest there may be more to tell.”
For this new data analysis, Fransquet and colleagues at Monash categorized the randomized controlled trial participants based on their platelet-related genetic score.
Among those who scored in the highest 20 percent, about 3.3 percent of those given a placebo developed dementia.
Yet only 1 percent of those who took aspirin developed dementia.
This represents a 70% lower relative risk from aspirin use in this subgroup.
“What is particularly interesting is that the signal was not linked to established genetic risk factors for Alzheimer’s disease and dementia,” says Fransquet.
“Instead, it points us toward platelet biology and gives us a new avenue to explore.”
Aspirin is arguably one of the greatest pharmacological advances of the 20th century and its use now plays a key role in the prevention of cardiovascular and cerebrovascular diseases.
This nonsteroidal anti-inflammatory drug may reduce the risk of heart attack, ischemic stroke, and blood clots when taken frequently by some patients.
Aspirin thins the blood, and while this can reduce the risk of clots, it can also increase the risk of bleeding, including internal bleeding.
The benefit of taking daily low-dose aspirin therefore only outweighs the risk in certain scenarios, and this balance between pros and cons is constantly swinging based on new research.
Much more evidence is needed to ensure the safety of taking low-dose aspirin in some people at risk of dementia.
The current analysis grouped together all forms of dementia, for example, but some types are more linked to vascular problems than others.
Additionally, the randomized trial only followed participants for a median duration of less than five years.
This means the study may have captured cases of dementia that progressed more quickly or were clinically apparent.
It is unclear to what extent daily low-dose aspirin would impact slower cases of cognitive decline.
The study, however, raises the possibility that genetic profiles could be used to personalize dementia prevention.
The research was published in Alzheimer’s and dementia.
This article was fact-checked by Rebecca Dyer and edited by Rebecca Dyer. Although we are proud of our process, we are only human. If you spot an error, please let us know.
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