Chisa Matsumoto1,2, Hisao Ogawa3, Yoshihiko Saito4, Sadanori Okada4,5, Hirofumi Soejima6, Mio Sakuma1, Izuru Masuda7, Masafumi Nakayama8, Naofumi Doi9, Hideaki Jinnouchi10, Masako Waki11, Takeshi Morimoto12. 1. Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan. 2. Center for Health Surveillance and Preventive Medicine, Tokyo Medical University, Tokyo, Japan. 3. National Cerebral and Cardiovascular Center, Osaka, Japan. 4. Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan. 5. Department of Diabetology, Nara Medical University, Nara, Japan. 6. Department of Cardiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 7. Medical Examination Center, Takeda Hospital, Kyoto, Japan. 8. Nakayama Cardiovascular Clinic, Kumamoto, Japan. 9. Department of Cardiovascular Medicine, Nara Prefectural Seiwa Medical Center, Nara, Japan. 10. Department of Internal Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan. 11. Department of Internal Medicine, Shizuoka City Shizuoka Hospital, Shizuoka, Japan. 12. Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan morimoto@kuhp.kyoto-u.ac.jp.
Abstract
OBJECTIVE: To evaluate and compare the efficacy of long-term use of low-dose aspirin for the prevention of dementia in men and women. RESEARCH DESIGN AND METHODS: This study is a follow-up cohort study of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial, which was a randomized, open-label, standard care-controlled trial examining the effects of low-dose aspirin on cardiovascular events. We followed up 2,536 Japanese patients with type 2 diabetes (T2D) enrolled in the JPAD trial from 2002 to 2017. The primary outcome of this post hoc analysis was the incidence of dementia, which was defined by the prescription of antidementia drugs or admission due to dementia. RESULTS: Among the originally enrolled patients, 2,121 (84%) retained their original allocation. During a median follow-up of 11.4 years, 128 patients developed dementia. The overall effect of low-dose aspirin on the prevention of dementia adjusted for age, sex, and other established risk factors was not significant (hazard ratio [HR] 0.82, 95% CI 0.58-1.16). However, a significant reduction was seen in the risk of dementia in women (HR 0.58, 95% CI 0.36-0.95), but not in men (HR 1.27, 95% CI 0.75-2.13) (P interaction = 0.03). CONCLUSIONS: Long-term use of low-dose aspirin may reduce the risk for dementia in women with T2D.
RCT Entities:
OBJECTIVE: To evaluate and compare the efficacy of long-term use of low-dose aspirin for the prevention of dementia in men and women. RESEARCH DESIGN AND METHODS: This study is a follow-up cohort study of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial, which was a randomized, open-label, standard care-controlled trial examining the effects of low-dose aspirin on cardiovascular events. We followed up 2,536 Japanese patients with type 2 diabetes (T2D) enrolled in the JPAD trial from 2002 to 2017. The primary outcome of this post hoc analysis was the incidence of dementia, which was defined by the prescription of antidementia drugs or admission due to dementia. RESULTS: Among the originally enrolled patients, 2,121 (84%) retained their original allocation. During a median follow-up of 11.4 years, 128 patients developed dementia. The overall effect of low-dose aspirin on the prevention of dementia adjusted for age, sex, and other established risk factors was not significant (hazard ratio [HR] 0.82, 95% CI 0.58-1.16). However, a significant reduction was seen in the risk of dementia in women (HR 0.58, 95% CI 0.36-0.95), but not in men (HR 1.27, 95% CI 0.75-2.13) (P interaction = 0.03). CONCLUSIONS: Long-term use of low-dose aspirin may reduce the risk for dementia in women with T2D.
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