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Effect of aspirin on activities of daily living disability in community-dwelling older adults

Woods, RL, Espinoza, S, Thao, LTP, Ernst, ME, Ryan, J, Wolfe, R, Shah, RC, Ward, SA, Storey, E, Nelson, MR ORCID: 0000-0001-9941-7161, Reid, CM, Lockery, JE, Orchard, SG, Trevaks, RE, Fitzgerald, SM, Stocks, NP, Williamson, JD, McNeil, JJ, Murray, AM and Newman, AB 2021 , 'Effect of aspirin on activities of daily living disability in community-dwelling older adults' , Journals of Gerontology. Series A: Biological Sciences and Medical Sciences , pp. 1-8 , doi: 10.1093/gerona/glaa316.

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Background: Cerebrovascular events, dementia and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin's effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.Methods: The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100mg aspirin versus placebo recruited 19,114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the U.S. Six basic ADLs were assessed every six months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after six months. Proportional hazards modelling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.Results: Over a median 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 versus 5.3 events/1000py; HR=0.81, 95% CI:0.66-1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability there were more deaths in the aspirin group (24 versus 12).Discussion: Low-dose aspirin in initially healthy older people did not reduce risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.

Item Type: Article
Authors/Creators:Woods, RL and Espinoza, S and Thao, LTP and Ernst, ME and Ryan, J and Wolfe, R and Shah, RC and Ward, SA and Storey, E and Nelson, MR and Reid, CM and Lockery, JE and Orchard, SG and Trevaks, RE and Fitzgerald, SM and Stocks, NP and Williamson, JD and McNeil, JJ and Murray, AM and Newman, AB
Keywords: clinical trials, aspirin, functional performance, physical function, preventive health care
Journal or Publication Title: Journals of Gerontology. Series A: Biological Sciences and Medical Sciences
Publisher: Gerontological Society Amer
ISSN: 1079-5006
DOI / ID Number: 10.1093/gerona/glaa316
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© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.

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