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Randomized Controlled Trial
. 2022 Oct 6;77(10):2007-2014.
doi: 10.1093/gerona/glab340.

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

Sara E Espinoza  1   2 , Robyn L Woods  3 , A R M Saifuddin Ekram  3 , Michael E Ernst  4   5 , Galina Polekhina  3 , Rory Wolfe  3 , Raj C Shah  6 , Stephanie A Ward  3 , Elsdon Storey  7 , Mark R Nelson  8 , Christopher M Reid  3 , Jessica E Lockery  3 , Suzanne G Orchard  3 , Ruth Trevaks  3 , Sharyn M Fitzgerald  3 , Nigel P Stocks  9 , Andy Chan  10 , John J McNeil  3 , Anne M Murray  11 , Anne B Newman  12 , Joanne Ryan  2
Affiliations
Randomized Controlled Trial

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

Sara E Espinoza et al. J Gerontol A Biol Sci Med Sci. .

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.

Keywords: Aspirin; Clinical trials; Frailty; Inflammation.

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Figures

Figure 1.
Figure 1.
Cumulative incidence of frailty, according to Fried frailty phenotype (A) and frailty index (B).
Figure 2.
Figure 2.
Forest plot of subgroup interaction effects on frailty incidence (Fried criteria).
Figure 3.
Figure 3.
Forest plot of subgroup interaction effects on frailty incidence (frailty index).
See this image and copyright information in PMC

References

    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–M157. doi: 10.1093/gerona/56.3.m146 - DOI - PubMed
    1. Bandeen-Roche K, Seplaki CL, Huang J, et al. Frailty in older adults: a nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci. 2015;70(11):1427–1434. doi: 10.1093/gerona/glv133 - DOI - PMC - PubMed
    1. Puts MTE, Toubasi S, Andrew MK, et al. Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies. Age Ageing. 2017;46(3):383–392. doi: 10.1093/ageing/afw247 - DOI - PMC - PubMed
    1. Villareal DT, Banks M, Sinacore DR, Siener C, Klein S. Effect of weight loss and exercise on frailty in obese older adults. Arch Intern Med. 2006;166(8):860–866. doi: 10.1001/archinte.166.8.860 - DOI - PubMed
    1. Hazuda HP, Pan Q, Florez H, et al. Association of intensive lifestyle and metformin interventions with frailty in the diabetes prevention program outcomes study. J Gerontol A Biol Sci Med Sci. 2021;76(5):929–936. doi: 10.1093/gerona/glaa295 - DOI - PMC - PubMed

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