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An Aspirin Every Other Day Won’t Keep Cognitive Decline Away

Long-term low-dose aspirin use did not protect against cognitive decline among healthy nonsmoking women 65 or older.

Studies of cognitive benefit from aspirin and other anti-inflammatory agents have yielded mixed results. The Women’s Health Study was a large, randomized, placebo-controlled study of vitamin E (600 IU on alternate days) and low-dose aspirin (100 mg on alternate days) for the prevention of cardiovascular disease and cancer. In this 4-year subgroup analysis of approximately 6400 women 65 or older, investigators administered tests of general cognition and verbal memory by telephone interview at 2-year intervals to women who had already received aspirin or placebo for an average of 5.6 years.

Global scores for cognitive function and scores for verbal memory did not differ between the two groups at initial testing, and the mean decline in overall cognitive performance was also similar between groups at each of the two follow-up assessments. The aspirin group performed better than the placebo group in category fluency (a test of executive brain function) at all three assessments. In the subsets of women who were current smokers or who had hyperlipidemia, the aspirin group experienced significantly less cognitive decline than did the placebo group.

Comment: In terms of category fluency, the effects of aspirin appeared to offset age-related decline by the equivalent of about 2.6 years; however, because only one test was used to assess executive brain function, the results should be interpreted with caution. In general, low-dose aspirin did not prevent cognitive decline during a 4-year period in nonsmoking, nonhyperlipidemic women. In women with known cardiovascular risk factors, aspirin might prevent some cognitive decline, but additional long-term studies are needed.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health May 24, 2007

Citation(s):

Kang JH et al. Low dose aspirin and cognitive function in the Women’s Health Study cognitive cohort. BMJ 2007 May 12; 334:987; [e-pub ahead of print]. (http://dx.doi.org/10.1136/bmj.39166.597836.BE)

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