Effect of aspirin on activities of daily living disability in community-dwelling older adults

Robyn L. Woods, Sara E Espinoza, Le Thi Phuong Thao, Michael E Ernst, Joanne Ryan, Rory Wolfe, Raj Shah, Stephanie Alison Ward, Elsdon Storey, Mark R. Nelson, Christopher M. Reid, Jessica E. Lockery, Suzanne Orchard, Ruth E. Trevaks, Sharyn Fitzgerald, Nigel Stocks, Jeff D Williamson, John J. McNeil, Anne M Murray, Anne B. Newmanon behalf of the ASPREE Investigator Group

Research output: Contribution to journalArticleResearchpeer-review

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

Results: Over a median 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 versus 5.3 events/1000py; HR=0.81, 95% 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 versus 12).

Discussion: Low-dose aspirin in initially healthy older people did not reduce risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.
Original languageEnglish
Number of pages8
JournalThe Journals of Gerontology: Biological Sciences and Medical Sciences
DOIs
Publication statusAccepted/In press - 26 Dec 2020

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