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Cited by 39Frailty in Older AdultsPharmaceutical Practices and Patient OutcomesAntiplatelet Therapy and Cardiovascular Diseases

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

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Espinoza, Sara E, Woods, Robyn L, Ekram, A R M Saifuddin, Ernst, Michael E, Polekhina, Galina, Wolfe, Rory, Shah, Raj C, Ward, Stephanie A +13 more·2022·The Journals of Gerontology: Series A
DOI 10.1093/gerona/glab340PMC PMC9536436
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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.

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Crossref · 10.1093/gerona/glab340

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Authors
Espinoza, S. E., Woods, R. L., Ekram, A. R. M. S., Ernst, M. E., Polekhina, G., Wolfe, R., Shah, R. C., Ward, S. A., Storey, E., Nelson, M. R., Reid, C. M., Lockery, J. E., Orchard, S. G., Trevaks, R., Fitzgerald, S. M., Stocks, N. P., Chan, A., McNeil, J. J., Murray, A. M., Newman, A. B., & Ryan, J.
Affiliations
  • The University of Texas at San Antonio Health Science Center (US)
  • Monash University (AU)
  • School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria , Australia
  • University of Iowa (US)
  • Rush University Medical Center (US)
  • University of Tasmania (AU)
  • The University of Adelaide (AU)
  • Massachusetts General Hospital (US)
  • University of Minnesota (US)
  • University of Pittsburgh (US)
  • South Texas Veterans Health Care System (US)
Corresponding author
Espinoza, Sara E
ORCID
Venue
The Journals of Gerontology: Series A
Publisher
Oxford University Press (OUP)
Published
2021-11-10
Volume
77
Issue
10
Pages
2007-2014
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/glab340
PMC
PMC9536436
OpenAlex
W3212464953
Cited by
39
References
56
Citations by year
2026: 8 · 2025: 11 · 2024: 8 · 2023: 9 · 2022: 3
FWCI
2.76
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • The Journals of Gerontology Series A (publishedVersion, public-domain)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, public-domain)
  • Figshare (submittedVersion, cc-by)
Funders
  • National Institutes of Health
  • National Cancer Institute (U01AG029824)
  • National Health and Medical Research Council (334047, 1127060)
  • Monash University
  • Victorian Cancer Agency
  • San Antonio Claude D. Pepper Older Americans Independence Center (P30 AG044271)
  • National Institute on Aging (R01 AG052697, R01 AG069690)
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Keywords
low-dose aspirin, frailty, frailty index, Fried frailty phenotype, community-dwelling older adults, ASPREE trial, chronic inflammation, incident frailty, nonagenarians
MeSH terms
Frailty, Aged, Aspirin, Persons with Disabilities, Disabled Persons, Humans, Phenotype, United States, Frail Elderly, Independent Living

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