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The Effect of Low-Dose Aspirin on Frailty Phenotype and Frailty Index in Community-Dwelling Older Adults in the ASPirin in Reducing Events in the Elderly Study


Espinoza, SE and Woods, RL and Ekram, ARMS and Ernst, ME and Polekhina, G and Wolfe, R and Shah, RC and Ward, SA and Storey, E and Nelson, MR and Reid, CM and Lockery, JE and Orchard, SG and Trevaks, R and Fitzgerald, SM and Stocks, NP and Chan, A and McNeil, JJ and Murray, AM and Newman, AB and Ryan, J, The Effect of Low-Dose Aspirin on Frailty Phenotype and Frailty Index in Community-Dwelling Older Adults in the ASPirin in Reducing Events in the Elderly Study, The journals of gerontology. Series A, Biological sciences and medical sciences, 77, (10) pp. 2007-2014. ISSN 1079-5006 (2022) [Refereed Article]

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DOI: doi:10.1093/gerona/glab340


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.

Item Details

Item Type:Refereed Article
Keywords:aspirin, clinical trials, frailty, inflammation
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Aged health care
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:155675
Year Published:2022
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2023-03-06
Last Modified:2023-03-06

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