Low-dose aspirin may protect against cognitive decline in elderly women

By Sarah Guy, medwireNews Reporter

Elderly women at risk for cardiovascular (CV) events who take low-dose acetylsalic acid (ASA; aspirin) exhibit less cognitive decline on the Mini Mental State Examination (MMSE) than their peers who do not take the drug, report researchers.

While the mechanism behind this apparent neurologic protective effect of ASA is not fully understood, it could relate to the antiplatelet effect and limited anti-inflammatory effect conferred by the drug in low doses, suggest the researchers.

"It is therefore possible that ASA might influence cognitive decline by enhancing the cerebral blood flow by reducing platelet aggression," write Anne Börjesson-Hanson (University of Gothenburg, Mölndal Sweden) and colleagues in BMJ Open.

The findings emerge from data for 681 women aged between 70 and 92 years who were participants of the Swedish Prospective Population Study of Women or the H70 Birth Cohort Study in Gothenburg.

In all, 129 women took low-dose ASA (75-160 mg daily) for CV risk at baseline in 2000, and 66 were still taking it at the 2005 follow up, which involved 489 of the original cohort. Follow ups included comprehensive social, functional, physical, neuropsychiatric, and neuropsychologic examination, explain the researchers.

Overall, average MMSE scores declined between follow ups, by an average of -0.88 for the entire cohort, and less for ASA users versus nonusers, at -0.05 versus -0.95, respectively.

After adjustment for factors including baseline MMSE, age at baseline, and CV risk score, the MMSE scores of women on low-dose ASA at baseline still declined significantly less than their nonuser counterparts.

A total of 601 (95%) women were classed as having high CV risk, defined as a 10% or higher 10-year chance of any CV disease event as categorized by the Framingham heart study, and data for these women showed similar associations between cognitive decline and ASA use.

Specifically, high CV risk women's MMSE scores decreased significantly less than their non-ASA-using counterparts, at -0.33 versus -0.95, respectively, report Börjesson-Hanson et al.

"Our finding that ASA use influenced cognitive function may reflect an effect on preclinical dementia, indicating that treatment must start early to have a sufficient neuroprotective effect," conclude the authors.

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