Aspirin and Risk of Dementia in Patients with Late-Onset Depression: A Population-Based Cohort Study
Ya-Hsu Yang1,2, Chih-Chiang Chiu3,4, Hao-Wei Teng2,5
1Department of Psychiatry, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
Insights
Aspirin use may reduce the risk of dementia in individuals with late onset depression (LOD). This study suggests a potential protective effect of aspirin for LOD patients at risk of dementia.
Area of Science:
- Geriatric Medicine
- Neurology
- Pharmacology
Background:
- Late onset depression (LOD) is frequently linked to vascular disease and an increased risk of dementia.
- Aspirin is commonly prescribed for cardiovascular disease and stroke prevention, but its impact on LOD patients with dementia risk is unclear.
Purpose of the Study:
- To investigate the association between aspirin use and the risk of developing dementia in patients diagnosed with late onset depression.
Main Methods:
- A population-based study utilized Taiwanese National Health Insurance data (1996-2009).
- Patients with LOD were identified, and aspirin users (≥75 mg daily for ≥6 months) were compared to non-users.
- Time-dependent Cox proportional hazards models and propensity score matching were employed for analysis.
Main Results:
- Among patients with LOD, aspirin users showed a significantly lower incidence of subsequent dementia compared to non-users (HR=0.734, p < 0.001).
- Propensity score matching confirmed a significantly lower cumulative incidence of dementia in LOD patients who used aspirin.
Conclusions:
- Aspirin use appears to be associated with a reduced risk of incident dementia in patients with late onset depression.
- Further validation through prospective clinical trials is recommended to confirm these findings.
Background:
Late onset depression (LOD) often occurs in the context of vascular disease and may be associated with risk of dementia. Aspirin is widely used to reduce the risk of cardiovascular disease and stroke. However, its role in patients with LOD and risk of dementia remains inconclusive. Materials and Methods. A population-based study was conducted using data from National Health Insurance of Taiwan during 1996-2009. Patients fulfil diagnostic criteria for LOD with or without subsequent dementia (incident dementia) and among whom users of aspirin (75 mg daily for at least 6 months) were identified. The time-dependent Cox proportional hazards model was applied for multivariate analyses. Propensity scores with the one-to-one nearest-neighbor matching model were used to select matching patients. Cumulative incidence of incident dementia after diagnosis of LOD was calculated by Kaplan-Meier Method.
Results:
A total of 6028 (13.4%) and 40,411 (86.6%) patients were defined as, with and without diagnosis of LOD, among whom 2,424 (41.9%) were aspirin users. Patients with LOD had more comorbidities such as cardiovascular diseases, diabetes, and hypertension comparing to those without LOD. Among patients with LOD, aspirin users had lower incidence of subsequent incident dementia than non-users (Hazard Ratio = 0.734, 95% CI 0.641-0.841, p < 0.001). After matching aspirin users with non-users by propensity scores-matching method, the cumulative incidence of incident dementia was significantly lower in aspirin users of LOD patients (p < 0.001). After matching aspirin users with non-users by propensity scores-matching method, the cumulative incidence of incident dementia was significantly lower in aspirin users of LOD patients (.
Conclusions:
Aspirin may be associated with a lower risk of incident dementia in patients with LOD. This beneficial effect of aspirin in LOD patients needs validation in prospective clinical trials and our results should be interpreted with caution.
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