IF YOU'RE AN ADULT IN your late 60s or 70s who's physically healthy, mentally sharp and trying to stay that way, taking a daily low-dose aspirin probably won't help that much, new research shows. Until now, there hasn't been much guidance for healthy older people trying to weigh the possible preventive effects of aspirin against its known increased risks of bleeding.
On Sept. 16, findings from a large new study on preventive aspirin use appeared in the New England Journal of Medicine. The three-pronged clinical trial encompassed more than 19,000 older adults in the U.S. and Australia. Participants were living independently, without heart disease, dementia or diabetes when they enrolled between 2010 and 2014 in the study sponsored by the National Institute on Aging.
Participants, whose average age was 74, were randomly assigned to take either a daily low-dose 100 milligram aspirin (the international equivalent of a standard 81 mg baby aspirin) or a placebo. Over a roughly five-year period, researchers followed these healthy seniors to see whether regular preventive aspirin extended their lifespan free of disability or dementia. However, there was no real difference between people on aspirin and those on a placebo, results showed.
That finding is likely to disappoint many people. "As a geriatrician, one of the most common discussions I have with older adults that are healthy and in the community is around ways they can optimize not only how long they live, but the quality of life they have," says study co-author Dr. Raj Shah, an associate professor of family medicine at the Rush Alzheimer's Disease Center at Rush University Medical Center in Chicago. "Most older adults are very curious about being able to maintain their memory and thinking skills, and their physical mobility. And if they also get to live longer, that's fine. But they want the combination."
The higher risk of bleeding from regular aspirin use is already well-established. "As we get older, bleeding risk goes up," says Dr. Randal Thomas, a preventive cardiologist in the department of cardiovascular medicine at the Mayo Clinic, who was not involved with the study. "For individuals above 75, we've known from past studies that they have such a high bleeding risk with aspirin, we particularly wouldn't recommend aspirin anyway." The new study helps confirm the need for caution with older adults, he says.
Colon cancer prevention is another reason many people take daily aspirin. "Studies over the last two decades have suggested that regular use of aspirin may have another important health benefit: decreasing the risk of developing or dying from some types of cancer," according to the website of the National Cancer Institute. Cancer of the colon and rectum has the most evidence supporting long-term aspirin use for prevention. However, the new study didn't find a cancer-prevention benefit for this particular group.
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