Nicola Veronese1,2, Brendon Stubbs3,4,5, Stefania Maggi2, Trevor Thompson6, Patricia Schofield3, Christoph Muller4,5, Ping-Tao Tseng7, Pao-Yen Lin8,9, André F Carvalho10, Marco Solmi1,11. 1. Institute for Clinical Research and Education in Medicine, Padova, Italy. 2. Aging Section, Institute of Neurosciences, Italian Research Council, Padova, Italy. 3. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. 4. South London and Maudsley National Health Service Foundation Trust, London, UK. 5. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 6. Faculty of Education and Health, University of Greenwich, London, UK. 7. Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan. 8. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 9. Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 10. Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil. 11. Department of Neuroscience, University of Padova, Padova, Italy.
Abstract
OBJECTIVES: To investigate whether low-dose aspirin (<300 mg/d) can influence the onset of cognitive impairment or dementia in observational studies and improve cognitive test scores in randomized controlled trials (RCTs) in participants without dementia. DESIGN: Systematic review and meta-analysis. SETTING: Observational and interventional studies. PARTICIPANTS: Individuals with no dementia or cognitive impairment initially. MEASUREMENTS: Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for the maximum number of covariates from each study, were used to summarize data on the incidence of dementia and cognitive impairment in observational studies. Standardized mean differences (SMDs) were used for cognitive test scores in RCTs. RESULTS: Of 2,341 potentially eligible articles, eight studies were included and provided data for 36,196 participants without dementia or cognitive impairment at baseline (mean age 66, 63% female). After adjusting for a median of three potential confounders over a median follow-up period of 6 years, chronic use of low-dose aspirin was not associated with onset of dementia or cognitive impairment (5 studies, N = 26,159; OR = 0.82, 95% CI = 0.55-1.22, P = .33, I2 = 67%). In three RCTs (N = 10,037; median follow-up 5 years), the use of low-dose aspirin was not associated with significantly better global cognition (SMD=0.005, 95% CI=-0.04-0.05, P = .84, I2 = 0%) in individuals without dementia. Adherence was lower in participants taking aspirin than in controls, and the incidence of adverse events was higher. CONCLUSION: This review found no evidence that low-dose aspirin buffers against cognitive decline or dementia or improves cognitive test scores in RCTs.
OBJECTIVES: To investigate whether low-dose aspirin (<300 mg/d) can influence the onset of cognitive impairment or dementia in observational studies and improve cognitive test scores in randomized controlled trials (RCTs) in participants without dementia. DESIGN: Systematic review and meta-analysis. SETTING: Observational and interventional studies. PARTICIPANTS: Individuals with no dementia or cognitive impairment initially. MEASUREMENTS: Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for the maximum number of covariates from each study, were used to summarize data on the incidence of dementia and cognitive impairment in observational studies. Standardized mean differences (SMDs) were used for cognitive test scores in RCTs. RESULTS: Of 2,341 potentially eligible articles, eight studies were included and provided data for 36,196 participants without dementia or cognitive impairment at baseline (mean age 66, 63% female). After adjusting for a median of three potential confounders over a median follow-up period of 6 years, chronic use of low-dose aspirin was not associated with onset of dementia or cognitive impairment (5 studies, N = 26,159; OR = 0.82, 95% CI = 0.55-1.22, P = .33, I2 = 67%). In three RCTs (N = 10,037; median follow-up 5 years), the use of low-dose aspirin was not associated with significantly better global cognition (SMD=0.005, 95% CI=-0.04-0.05, P = .84, I2 = 0%) in individuals without dementia. Adherence was lower in participants taking aspirin than in controls, and the incidence of adverse events was higher. CONCLUSION: This review found no evidence that low-dose aspirin buffers against cognitive decline or dementia or improves cognitive test scores in RCTs.
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