Effects of aspirin on the long-term management of depression in older people: a double-blind randomised placebo-controlled trial

Michael Berk, Bruno Agustini, Robyn L. Woods, Mark R. Nelson, Raj C. Shah, Christopher M. Reid, Elsdon Storey, Sharyn M. Fitzgerald, Jessica E. Lockery, Rory Wolfe, Mohammadreza Mohebbi, Seetal Dodd, Anne M. Murray, Nigel Stocks, Paul B. Fitzgerald, Catherine Mazza, John J. McNeil

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17 Citations (Scopus)


Late-life depression is common and often inadequately managed using existing therapies. Depression is also associated with increased markers of inflammation, suggesting a potential role for anti-inflammatory agents. ASPREE-D is a sub-study of ASPREE, a large multi-centre, population-based, double-blind, placebo-controlled trial of aspirin vs placebo in older Australian and American adults (median follow-up: 4.7 years) of whom 1879 were depressed at baseline. Participants were given 100 mg daily dose of aspirin or placebo. Depressive symptoms were assessed annually using the validated, self-rated short version of the Center for Epidemiological Studies Depression scale. There was a significant increase in depressive scores (0.6; 95% CI 0.2 to 0.9; χ2 (1) = 10.37; p = 0.001) and a decreased score in the mental health component of a quality of life scale (–0.7; 95% CI –1.4 to –0.1; χ2 (1) = 4.74; p = 0.029) in the aspirin group compared to the placebo group. These effects were greater in the first year of follow-up and persisted throughout the study, albeit with small to very small effect sizes. This study failed to demonstrate any benefit of aspirin in the long-term course of depression in this community-dwelling sample of older adults over a 5-year period, and identified an adverse effect of aspirin in the course of depression in those with pre-existing depressive symptoms.

Original languageEnglish
Pages (from-to)5161–5170
Number of pages10
JournalMolecular Psychiatry
Issue number9
Publication statusPublished - Sept 2021

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