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Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial

Sarah Parish1,2, Marion Mafham2, Alison Offer2

  • 1MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK.

European Heart Journal
|April 8, 2022
PubMed

Insights

Aspirin use in people with diabetes did not significantly affect dementia risk. Further research is needed to determine if low-dose aspirin offers modest benefits for cognitive health.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Aspirin is a common preventative for cardiovascular disease.
  • Its impact on dementia and cognitive impairment remains unclear.
  • Individuals with diabetes are at higher risk for cardiovascular events and cognitive decline.

Purpose of the Study:

  • To investigate the effect of daily aspirin on the incidence of dementia and cognitive impairment in individuals with diabetes.
  • To analyze cognitive outcomes in the ASCEND trial cohort.

Main Methods:

  • The ASCEND trial randomized 15,480 UK participants with diabetes and no prior cardiovascular disease to aspirin (100 mg daily) or placebo.
  • Cognitive outcomes, defined as 'broad dementia' (dementia, cognitive impairment, or confusion), were assessed in 15,427 participants over a mean of 7.4 years.
  • Ascertainment included reports from participants, carers, general practitioners, and hospital diagnoses.

Main Results:

  • The incidence of broad dementia was similar between the aspirin group (7.1%) and the placebo group (7.8%).
  • The rate ratio for broad dementia was 0.91 (95% CI, 0.81-1.02).
  • The confidence interval excluded a proportional hazard increase greater than 2% and a proportional benefit greater than 19%.

Conclusions:

  • Daily aspirin use does not appear to have a substantial effect on the risk of dementia in individuals with diabetes.
  • Larger trials or meta-analyses are required to detect potential modest benefits (10-15%) of aspirin on dementia risk over 5-7 years.
Abstract

Keywords:
AspirinCardiovascular diseaseDementia

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