A study conducted on the Womens Health study cognitive cohort between 1998 and 2004 by researcher Kang and team, showed no significant differences in cognitive function and cognitive decline patterns in elderly women who were on low dose Aspirin (acetylsalicylic acid) therapy for nearly 10 years.

In the study, 6377 women, aged 65yrs or more, were given low dose Aspirin (100mg on alternate days), or placebo for a mean period of 9.6 years. Three cognitive assessments were done over telephone at 2 year intervals. Five tests, aimed at measuring general cognition, verbal memory, and category fluency, were administered. Two pre-specified outcomes were measured: A primary outcome which was a global score averaging all the five tests of cognition and a secondary outcome which included a verbal memory score, averaging 4 measures of verbal memory. Upon initial assessment it was found that the differences in the cognitive performance and cognitive decline between the placebo group and the Aspirin group was as little as 0.01%.
Verbal memory did not show much variation either. The only area in which Aspirin seemed to have some benefit (20% lower risk) was “category fluency”.

Aspirin has been used widely in the management of cognitive decline associated with vascular dementia (cognitive decline due to vascular risk factors) as observed in a Cochrane review published in 2000. The reviewers pointed out that 80% of the elderly in U.K. with vascular risk factors were being prescribed Aspirin. They found no evidence supporting the beneficial effects of Aspirin in vascular dementia and stressed the need for larger trials to understand the effects of Aspirin on the cognitive function.

Another study conducted in 2003 by Jonker et al showed some protective effect on “Immediate recall capacity” in individuals 75 years or older upon prolonged use of Aspirin. No significant effect was noted in individuals between 62-75 years of age. In the study, the protective effect of NSAIDs and Aspirin (100mg daily) on cognitive functions of the elderly was investigated. 1007 individuals, 62-85 years of age were followed up for 3 years. Other NSAIDs did not have any significant beneficial effect on cognition in the study.

Aspirin and other NSAIDs are considered to be effective in cognitive protection due to the recognition of neuronal inflammation as a cause of dementia in conditions like Alzheimer disease, and the general observation of reduced incidence of Alzheimer disease after regular use of NSAIDs for conditions like arthritis. A study reported in 2003 in the European Journal of Clinical Pharmacology concluded that Aspirin protects against Alzheimer disease, and recommended larger controlled trials.

With no definitive evidence on cognitive improvement or stabilization demonstrated in normal individuals or in individuals at risk for vascular dementia or Alzheimer disease, use of Aspirin for cognitive protection needs to be reconsidered.

References

1. Kang JH, Cook N, Manson J, Buring JE, Grodstein F. Low dose aspirin and cognitive function in the women’s health study cognitive cohort. BMJ doi:10.1136/bmj.39166.597836.BE(published 27 April 2007).

2. Jonker C, Comijs HC, Smit JH Does aspirin or other NSAIDs reduce the risk of cognitive decline in elderly persons? Results from a population-based study. Neurobiol Aging. 2003 Jul-Aug;24(4):583-8.

3. Williams PS, Rands G, Orrel M, Spector A. Aspirin for vascular dementia.Cochrane Database Syst Rev. 2000;(4):CD001296.

4. Nilsson SE, Johansson B, Takkinen S, Does aspirin protect against Alzheimer’s dementia? A study in a Swedish population-based sample aged > or =80 years. Eur J Clin Pharmacol. 2003 Aug;59(4):313-9.