Effect of aspirin on disability-free survival in the healthy elderly

Background: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disabilityfree life in healthy seniors is unclear. Methods: From 2010 through 2014, we enrolled community-dwelling perso...

Full description

Bibliographic Details
Main Authors: McNeil, J., Woods, R., Nelson, M., Reid, Christopher, Kirpach, B., Wolfe, R., Storey, E., Shah, R., Lockery, J., Tonkin, A., Newman, A., Williamson, J., Margolis, K., Ernst, M., Abhayaratna, W., Stocks, N., Fitzgerald, S., Orchard, S., Trevaks, R., Beilin, L., Donnan, G., Gibbs, P., Johnston, C., Ryan, J., Radziszewska, B., Grimm, R., Murray, A.
Format: Journal Article
Published: Massachusetts Medical Society 2018
Online Access:http://hdl.handle.net/20.500.11937/74488
_version_ 1848763289283067904
author McNeil, J.
Woods, R.
Nelson, M.
Reid, Christopher
Kirpach, B.
Wolfe, R.
Storey, E.
Shah, R.
Lockery, J.
Tonkin, A.
Newman, A.
Williamson, J.
Margolis, K.
Ernst, M.
Abhayaratna, W.
Stocks, N.
Fitzgerald, S.
Orchard, S.
Trevaks, R.
Beilin, L.
Donnan, G.
Gibbs, P.
Johnston, C.
Ryan, J.
Radziszewska, B.
Grimm, R.
Murray, A.
author_facet McNeil, J.
Woods, R.
Nelson, M.
Reid, Christopher
Kirpach, B.
Wolfe, R.
Storey, E.
Shah, R.
Lockery, J.
Tonkin, A.
Newman, A.
Williamson, J.
Margolis, K.
Ernst, M.
Abhayaratna, W.
Stocks, N.
Fitzgerald, S.
Orchard, S.
Trevaks, R.
Beilin, L.
Donnan, G.
Gibbs, P.
Johnston, C.
Ryan, J.
Radziszewska, B.
Grimm, R.
Murray, A.
author_sort McNeil, J.
building Curtin Institutional Repository
collection Online Access
description Background: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disabilityfree life in healthy seniors is unclear. Methods: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or =65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end point was a composite of death, dementia, or persistent physical disability. Secondary end points reported in this article included the individual components of the primary end point and major hemorrhage. Results: A total of 19,114 persons with a median age of 74 years were enrolled, of whom 9525 were randomly assigned to receive aspirin and 9589 to receive placebo. A total of 56.4% of the participants were women, 8.7% were nonwhite, and 11.0% reported previous regular aspirin use. The trial was terminated at a median of 4.7 years of follow-up after a determination was made that there would be no benefit with continued aspirin use with regard to the primary end point. The rate of the composite of death, dementia, or persistent physical disability was 21.5 events per 1000 person-years in the aspirin group and 21.2 per 1000 person-years in the placebo group (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11; P = 0.79). The rate of adherence to the assigned intervention was 62.1% in the aspirin group and 64.1% in the placebo group in the final year of trial participation. Differences between the aspirin group and the placebo group were not substantial with regard to the secondary individual end points of death from any cause (12.7 events per 1000 person-years in the aspirin group and 11.1 events per 1000 person-years in the placebo group), dementia, or persistent physical disability. The rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%; hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001). Conclusions: Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo.
first_indexed 2025-11-14T11:01:06Z
format Journal Article
id curtin-20.500.11937-74488
institution Curtin University Malaysia
institution_category Local University
last_indexed 2025-11-14T11:01:06Z
publishDate 2018
publisher Massachusetts Medical Society
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-744882019-07-16T03:12:37Z Effect of aspirin on disability-free survival in the healthy elderly McNeil, J. Woods, R. Nelson, M. Reid, Christopher Kirpach, B. Wolfe, R. Storey, E. Shah, R. Lockery, J. Tonkin, A. Newman, A. Williamson, J. Margolis, K. Ernst, M. Abhayaratna, W. Stocks, N. Fitzgerald, S. Orchard, S. Trevaks, R. Beilin, L. Donnan, G. Gibbs, P. Johnston, C. Ryan, J. Radziszewska, B. Grimm, R. Murray, A. Background: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disabilityfree life in healthy seniors is unclear. Methods: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or =65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end point was a composite of death, dementia, or persistent physical disability. Secondary end points reported in this article included the individual components of the primary end point and major hemorrhage. Results: A total of 19,114 persons with a median age of 74 years were enrolled, of whom 9525 were randomly assigned to receive aspirin and 9589 to receive placebo. A total of 56.4% of the participants were women, 8.7% were nonwhite, and 11.0% reported previous regular aspirin use. The trial was terminated at a median of 4.7 years of follow-up after a determination was made that there would be no benefit with continued aspirin use with regard to the primary end point. The rate of the composite of death, dementia, or persistent physical disability was 21.5 events per 1000 person-years in the aspirin group and 21.2 per 1000 person-years in the placebo group (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11; P = 0.79). The rate of adherence to the assigned intervention was 62.1% in the aspirin group and 64.1% in the placebo group in the final year of trial participation. Differences between the aspirin group and the placebo group were not substantial with regard to the secondary individual end points of death from any cause (12.7 events per 1000 person-years in the aspirin group and 11.1 events per 1000 person-years in the placebo group), dementia, or persistent physical disability. The rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%; hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001). Conclusions: Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo. 2018 Journal Article http://hdl.handle.net/20.500.11937/74488 10.1056/NEJMoa1800722 Massachusetts Medical Society restricted
spellingShingle McNeil, J.
Woods, R.
Nelson, M.
Reid, Christopher
Kirpach, B.
Wolfe, R.
Storey, E.
Shah, R.
Lockery, J.
Tonkin, A.
Newman, A.
Williamson, J.
Margolis, K.
Ernst, M.
Abhayaratna, W.
Stocks, N.
Fitzgerald, S.
Orchard, S.
Trevaks, R.
Beilin, L.
Donnan, G.
Gibbs, P.
Johnston, C.
Ryan, J.
Radziszewska, B.
Grimm, R.
Murray, A.
Effect of aspirin on disability-free survival in the healthy elderly
title Effect of aspirin on disability-free survival in the healthy elderly
title_full Effect of aspirin on disability-free survival in the healthy elderly
title_fullStr Effect of aspirin on disability-free survival in the healthy elderly
title_full_unstemmed Effect of aspirin on disability-free survival in the healthy elderly
title_short Effect of aspirin on disability-free survival in the healthy elderly
title_sort effect of aspirin on disability-free survival in the healthy elderly
url http://hdl.handle.net/20.500.11937/74488