In an effort to extend the length of a disability-free life for older adults, researchers from Wake Forest University Baptist Medical Center are partnering with colleagues from across the US and Australia in the largest international trial ever sponsored by the US National Institute on Aging (NIA).
The Aspirin in Reducing Events in the Elderly (ASPREE) study aims to assess whether aspirin can not only prolong life, but a life free of physical disability and/or dementia for healthy older people.
According to Jamehl Demons, M.D., an assistant professor of geriatric medicine and an ASPREE investigator from Wake Forest Baptist, “We have, through technology, been able to prolong life but not necessarily function in our seniors. This study will allow us to look at a possible mechanism for maintaining functional independence. The population of age 70+ is such a vulnerable one for functional decline; this is the perfect group to target for interventions such as aspirin.”
While it is known that aspirin prevents heart attacks and strokes in people with established heart disease – benefits which clearly outweigh any risks associated with aspirin, such as bleeding – the role of aspirin in people without a history of cardiovascular disease is less certain.
“In the US, Australia and elsewhere, people are living longer so identifying treatments to prolong life free of physical disability and memory problems is increasingly important,” said ASPREE investigator Anne Murray, M.D., MSc, an epidemiologist and geriatrician, and associate professor of medicine and geriatrics at the University of Minnesota. “Aspirin is a potentially useful drug as it is cheap and widely available.”
To date, very little information is available about the overall effects of aspirin in older adults, because most trials focus on middle-aged people. The ASPREE study, for the first time, will determine whether the potential benefits of low dose aspirin outweigh the risks specifically for people age 70 and older.
“Because of its proven effectiveness in preventing second events, many doctors have also prescribed aspirin to prevent heart attacks and strokes in otherwise healthy people,” said Professor John McNeil, Head of the Monash School of Public Health and Preventative Medicine in Australia, and also a principal investigator for ASPREE. “However, in the last couple of years, serious doubts have been raised about the evidence supporting this practice, and as a result, editorials in major medical journals have called for this question to be settled.”
The ASPREE study will enroll 6,500 healthy individuals age 70 and over in the US and another 12,500 in Australia. Two hundred of those participants will be local from the Triad area. All eligible participants will be randomly assigned to take either low dose aspirin or placebo daily for about 5 years.
Patients will receive initial measurements on specific health markers, as well as functional and cognitive ability, and changes in these will be monitored throughout the study.
"The magnitude of this study will mean we will be able to answer a question looming in minds of physicians and patients for quite some time: how to remain mentally and physically independent as we age," Demons said.
ASPREE is being conducted in clinics and universities located in select cities in Alabama, Florida, Illinois, Iowa, Michigan, Minnesota, New Mexico, North Carolina, Pennsylvania, Rhode Island, and Texas. More information can be found at www.ASPREE.org.
Originally developed as a pilot study by Monash University in Australia, the ASPREE study is being conducted in partnership between Monash University, the Berman Center for Outcomes and Clinical Research in Minneapolis, MN, and the National Institute on Aging.