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

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10 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)2007-2014
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number11
Publication statusPublished - Nov 2021


  • Aspirin
  • Clinical trials
  • Functional performance
  • Physical function
  • Preventive health care

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