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Aspirin associated with reduced risk of disability loss in specific elderly populationsTrial shows aspirin may lower risk of disability for some

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Key Takeaway
Note that aspirin's impact on disability-free survival may vary significantly among different patient subgroups.

The study evaluated the impact of daily aspirin on disability-free survival among older participants who identified as non-Hispanic Black or Hispanic. The primary outcome measured death, persistent physical disability, or dementia. The analysis focused on how aspirin compared to a placebo in preventing these outcomes over time.

Results indicated that aspirin was associated with a lower risk of loss of disability-free survival compared to placebo. However, the benefit appeared to be heterogeneous across the study population. Specifically, a lower risk was observed in the group with the highest predicted benefit, while no significant association was found in the group with the lowest predicted benefit.

The authors noted that these findings are based on post-hoc models and require external validation before they can be applied in clinical practice. Because the analysis was conducted after the trial was completed, the certainty of these specific subgroup findings is limited. Clinicians should note that the observed benefits may be concentrated in specific subsets of patients, but the overall evidence remains preliminary.

Researchers analyzed data from a clinical trial involving 1,270 participants aged 65 and older who identified as non-Hispanic Black or Hispanic. The study looked at the effects of taking a daily 100-mg dose of aspirin compared to a placebo. The primary goal was to see if aspirin could reduce the loss of disability-free survival, which includes death, persistent physical disability, or dementia.

The results showed that aspirin was associated with a lower risk of these conditions compared to a placebo. However, the benefit was not the same for everyone. The study found that the benefit was most significant in a specific group predicted to have the highest benefit. In contrast, the group predicted to have the lowest benefit did not show a significant reduction in risk.

It is important to note that these findings come from a post-hoc analysis, which means the researchers looked at the data after the trial was completed. Because of this method, the evidence is not yet certain enough to change standard medical practice. These results require further validation before they can be used to guide clinical decisions for patients.

What this means for you:
Aspirin may lower disability risks for some seniors, but results are preliminary and need more study.

Common questions

Who was included in this study?

The study included 1,270 participants who were at least 65 years old and self-identified as non-Hispanic Black or Hispanic. They were part of the ASPREE trial to see how a daily 100-mg dose of aspirin affected their health compared to a placebo.

What were the main findings regarding aspirin?

The study found that aspirin was associated with a lower risk of death, physical disability, or dementia compared to a placebo. However, this benefit was most notable in a specific group predicted to have the highest benefit, while it was not significant for the group predicted to have the lowest benefit.

Is this finding enough to change how doctors prescribe aspirin?

Not yet. Because these results came from a post-hoc analysis, the evidence is considered to have low certainty. The findings need more testing and validation before they can be used to change standard medical treatments or recommendations.

Study Details

Study typeRct
EvidenceLevel 2
PublishedAug 2026
View Original Abstract ↓
Importance: The ASPREE randomized trial found no overall benefit of low-dose aspirin for disability-free survival among older adults. However, individual estimates in pre-specified subgroups indicated potential benefit among racial and ethnic minoritized participants in the United States (US). Objective: To evaluate whether the effect of low-dose aspirin vs placebo on disability-free survival differed across US Black and Hispanic ASPREE participants using individualized treatment-effect estimation. Design, Setting, and Participants: Post hoc clinical trial analysis of ASPREE, a randomized, double-blind, placebo-controlled clinical trial of daily low-dose aspirin vs placebo. This analysis included US ASPREE participants who self-identified as non-Hispanic Black or Hispanic, were aged 65 years or older, and had complete baseline predictor and outcome data. Interventions: Randomization to daily 100-mg aspirin or placebo. Main Outcomes and Measures: The primary outcome was loss of disability-free survival, defined as death, persistent physical disability, or dementia. Individualized treatment effects were estimated post hoc using a Random Survival Forest X-learner. Heterogeneity was evaluated on the relative scale with Cox proportional hazards models and on the absolute scale with 5-year risk differences. Results: Among 2411 US ASPREE participants, 1270 were included in the Black and Hispanic analytic cohort (897 non-Hispanic Black and 373 Hispanic participants; mean age, 71.8 years). Aspirin was associated with lower risk of disability-free survival loss compared with placebo (hazard ratio [HR], 0.65; 95% CI, 0.45-0.93). In model-derived tertiles, aspirin was associated with lower risk in the greatest predicted-benefit group (HR, 0.36; 95% CI, 0.19-0.71; 5-year absolute risk difference [ARD], -11.1 percentage points; 95% CI, -22.0 to -0.1) but not in the lowest predicted-benefit group (HR, 1.26; 95% CI, 0.70-2.27; ARD, +3.9 percentage points; 95% CI, -5.9 to 13.6). Conclusions and Relevance: In these analyses of US Black and Hispanic ASPREE participants, aspirin effects on disability-free survival appear to be heterogeneous, with benefit concentrated in a subset of participants. Because these findings are from post-hoc models, they should be externally validated before being incorporated into clinical decision-making. Trial Registration: ClinicalTrials.gov Identifier: NCT01038583; https://clinicaltrials.gov/study/NCT01038583
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