Low dose aspirin and cognitive function in the women's health study cognitive cohort

doi:10.1136/bmj.39166.597836.BE

BMJ 2007;334:987 (12 May), doi:10.1136/bmj.39166.597836.BE (published 27 April 2007)

Research

Low dose aspirin and cognitive function in the women's health study cognitive cohort

Jae Hee Kang, instructor¹, Nancy Cook, associate professor², JoAnn Manson, professor², Julie E Buring, professor², Francine Grodstein, associate professor¹

¹ Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, ² Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital

Correspondence to: J H Kang nhjhk{at}channing.harvard.edu

Objective To determine whether low dose aspirin protects womenaged 65 or more against cognitive decline.

Design Cohort study within both arms of the women's health study,a randomised, double blind, placebo controlled trial of lowdose aspirin for the primary prevention of cardiovascular diseaseand cancer, 1992-5.

Setting Women's health study, 1998-2004.

Participants 6377 women aged 65 or more.

Interventions Low dose aspirin (100 mg on alternate days) orplacebo for a mean of 9.6 years.

Main outcome measures Women had three cognitive assessmentsat two year intervals by telephone. The battery to assess cognitionincluded five tests measuring general cognition, verbal memory,and category fluency. The primary prespecified outcome was aglobal score, averaging performance across all tests. The keysecondary outcome was a verbal memory score, averaging performanceon four measures of verbal memory.

Results At the initial assessment (mean 5.6 years after randomisation)cognitive performance in the aspirin group was similar to thatof the placebo group (mean difference in global score –0.01,95% confidence interval –0.04 to 0.02). Mean decline inthe global score from the first to the final cognitive assessmentwas also similar in the aspirin compared with placebo groups(mean difference 0.01, –0.02 to 0.04). The risk of substantialdecline (in the worst 10th centile of decline) was also comparablebetween the groups (relative risk 0.92, 0.77 to 1.10). Findingswere similar for verbal memory; however, a 20% lower risk wasobserved for decline in category fluency with aspirin (relativerisk 0.80, 0.67 to 0.97).

Conclusion Long term use of low dose aspirin does not provideoverall benefits for cognition among generally healthy womenaged 65 or more.

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Too little, too late?: Richard J Prettyman
BMJ 2007 334: 1071. [Extract] [Full Text] [PDF]

Too much of many good things?: Douglas Kamerow
BMJ 2007 334: 0. [Extract] [Full Text]

Aspirin and cognitive function: Lawrence J Whalley and Donald H R Mowat
BMJ 2007 334: 961-962. [Extract] [Full Text] [PDF]

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BMJ 2001 322: 1447-1451. [Abstract] [Full Text] [PDF]

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