Effect of Aspirin on Activities of Daily Living Disability in Community-Dwelling Older Adults.

Abstract

BACKGROUND:

Cerebrovascular events, dementia, and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin's effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.

METHODS:

The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100 mg aspirin versus placebo recruited 19 114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the United States. Six basic ADLs were assessed every 6 months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after 6 months. Proportional hazards modeling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.

RESULTS:

Over a median of 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing, and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 vs 5.3 events/1000 py; hazard ratio [HR] = 0.81, 95% confidence interval [CI]: 0.66-1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability, there were more deaths in the aspirin group (24 vs 12).

DISCUSSION:

Low-dose aspirin in initially healthy older people did not reduce the risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.

• Authors: Robyn L Woods, Sara Espinoza, Le T P Thao, Michael E Ernst, Joanne Ryan, Rory Wolfe, Raj C Shah, Stephanie A Ward, Elsdon Storey, Mark R Nelson, Christopher M Reid, Jessica E Lockery, Suzanne G Orchard, Ruth E Trevaks, Sharyn M Fitzgerald, Nigel P Stocks, Jeff D Williamson, John J McNeil, Anne M Murray, Anne B Newman
• Journal: The journals of gerontology. Series A, Biological sciences and medical sciences (J Gerontol A Biol Sci Med Sci) Vol. 76 Issue 11 Pg. 2007-2014 (10 13 2021) ISSN: 1758-535X [Electronic] United States
• PMID: 33367621 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Aspirin

Topics

• Activities of Daily Living
• Aged
• Aging
• Aspirin
• Disability Evaluation
• Disabled Persons
• Humans
• Independent Living
• United States (epidemiology)