Sara E Espinoza1,2, Robyn L Woods3, A R M Saifuddin Ekram3, Michael E Ernst4,5, Galina Polekhina3, Rory Wolfe3, Raj C Shah6, Stephanie A Ward3, Elsdon Storey7, Mark R Nelson8, Christopher M Reid3, Jessica E Lockery3, Suzanne G Orchard3, Ruth Trevaks3, Sharyn M Fitzgerald3, Nigel P Stocks9, Andy Chan10, John J McNeil3, Anne M Murray11, Anne B Newman12, Joanne Ryan2. 1. Division of Geriatrics, Gerontology and Palliative Medicine, Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, Texas, USA. 2. Geriatrics Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, Texas, USA. 3. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 4. Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA. 5. Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA. 6. Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA. 7. Van Cleef/Roet Centre for Nervous Diseases, Monash University, Melbourne, Victoria, Australia. 8. Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia. 9. Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, Australia. 10. Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 11. Berman Center for Clinical Outcomes and Research, Hennepin Health Research Institute and Division of Geriatrics, Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis, Minnesota, USA. 12. Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Abstract
BACKGROUND: Frailty is associated with chronic inflammation, which may be modified by aspirin. The purpose of this study was to determine whether low-dose aspirin reduces incident frailty in healthy older adult participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial. METHODS: In the United States and Australia, 19 114 community-dwelling individuals aged ≥70 and older (U.S. minorities ≥65 years) and free of overt cardiovascular disease, persistent physical disability, and dementia were enrolled in ASPREE, a double-blind, placebo-controlled trial of 100-mg daily aspirin versus placebo. Frailty, a prespecified study end point, was defined according to a modified Fried frailty definition (Fried frailty) and the frailty index based on the deficit accumulation model (frailty index). Competing risk Cox proportional hazard models were used to compare time to incident frailty by aspirin versus placebo. Sensitivity analysis was conducted to include frailty data with and without imputation of missing data. RESULTS: Over a median 4.7 years, 2 252 participants developed incident Fried frailty, and 4 451 had incident frailty according to the frailty index. Compared with placebo, aspirin treatment did not alter the risk of incident frailty (Fried frailty hazard ratio [HR]: 1.04, 95% confidence interval [CI] 0.96-1.13; frailty index HR: 1.03, 95% CI 0.97-1.09). The proportion of individuals classified as frail, and the trajectory in continuous frailty scores over time, were not different between the aspirin and placebo treatment groups. The results were consistent across a series of subgroups. CONCLUSIONS: Low-dose aspirin use in healthy older adults when initiated in older ages does not reduce risk of incident frailty or the trajectory of frailty. Published by Oxford University Press on behalf of The Gerontological Society of America 2021.
BACKGROUND: Frailty is associated with chronic inflammation, which may be modified by aspirin. The purpose of this study was to determine whether low-dose aspirin reduces incident frailty in healthy older adult participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial. METHODS: In the United States and Australia, 19 114 community-dwelling individuals aged ≥70 and older (U.S. minorities ≥65 years) and free of overt cardiovascular disease, persistent physical disability, and dementia were enrolled in ASPREE, a double-blind, placebo-controlled trial of 100-mg daily aspirin versus placebo. Frailty, a prespecified study end point, was defined according to a modified Fried frailty definition (Fried frailty) and the frailty index based on the deficit accumulation model (frailty index). Competing risk Cox proportional hazard models were used to compare time to incident frailty by aspirin versus placebo. Sensitivity analysis was conducted to include frailty data with and without imputation of missing data. RESULTS: Over a median 4.7 years, 2 252 participants developed incident Fried frailty, and 4 451 had incident frailty according to the frailty index. Compared with placebo, aspirin treatment did not alter the risk of incident frailty (Fried frailty hazard ratio [HR]: 1.04, 95% confidence interval [CI] 0.96-1.13; frailty index HR: 1.03, 95% CI 0.97-1.09). The proportion of individuals classified as frail, and the trajectory in continuous frailty scores over time, were not different between the aspirin and placebo treatment groups. The results were consistent across a series of subgroups. CONCLUSIONS: Low-dose aspirin use in healthy older adults when initiated in older ages does not reduce risk of incident frailty or the trajectory of frailty. Published by Oxford University Press on behalf of The Gerontological Society of America 2021.
Authors: Keenan A Walker; Jeremy Walston; Rebecca F Gottesman; Anna Kucharska-Newton; Priya Palta; B Gwen Windham Journal: J Gerontol A Biol Sci Med Sci Date: 2019-02-15 Impact factor: 6.053
Authors: Nancy Fugate Woods; Andrea Z LaCroix; Shelly L Gray; Aaron Aragaki; Barbara B Cochrane; Robert L Brunner; Kamal Masaki; Anne Murray; Anne B Newman Journal: J Am Geriatr Soc Date: 2005-08 Impact factor: 5.562
Authors: Joshua I Barzilay; Caroline Blaum; Tisha Moore; Qian Li Xue; Calvin H Hirsch; Jeremy D Walston; Linda P Fried Journal: Arch Intern Med Date: 2007-04-09
Authors: Robyn L Woods; Sara Espinoza; Le T P Thao; Michael E Ernst; Joanne Ryan; Rory Wolfe; Raj C Shah; Stephanie A Ward; Elsdon Storey; Mark R Nelson; Christopher M Reid; Jessica E Lockery; Suzanne G Orchard; Ruth E Trevaks; Sharyn M Fitzgerald; Nigel P Stocks; Jeff D Williamson; John J McNeil; Anne M Murray; Anne B Newman Journal: J Gerontol A Biol Sci Med Sci Date: 2021-10-13 Impact factor: 6.053
Authors: A R M Saifuddin Ekram; Robyn L Woods; Joanne Ryan; Sara E Espinoza; Julia F M Gilmartin-Thomas; Raj C Shah; Raaj Mehta; Bharati Kochar; Judy A Lowthian; Jessica Lockery; Suzanne Orchard; Mark Nelson; Michelle A Fravel; Danny Liew; Michael E Ernst Journal: Arch Gerontol Geriatr Date: 2022-03-23 Impact factor: 4.163