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; Robyn L Woods; A R M Saifuddin Ekram; Michael E Ernst; Galina Polekhina; Rory Wolfe; Raj C Shah; Stephanie A Ward; Elsdon Storey; Mark R Nelson; Christopher M Reid; Jessica E Lockery; Suzanne G Orchard; Ruth Trevaks; Sharyn M Fitzgerald; Nigel P Stocks; Andy Chan; John J McNeil; Anne M Murray; Anne B Newman; Joanne Ryan

doi:10.1093/gerona/glab340

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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

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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, Robyn L Woods, A R M Saifuddin Ekram, Michael E Ernst, Galina Polekhina, Rory Wolfe, Raj C Shah, Stephanie A Ward, Elsdon Storey, Mark R Nelson, …

The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.77(10), pp.2007-2014

10/2022

DOI: 10.1093/gerona/glab340

PMCID: PMC9536436

PMID: 34758073

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Abstract

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.

Details

Title: Subtitle: 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
Creators: Sara E Espinoza - The University of Texas Health Science Center at San Antonio
Robyn L Woods - Monash University
A R M Saifuddin Ekram - Monash University
Michael E Ernst - University of Iowa
Galina Polekhina - Monash University
Rory Wolfe - Monash University
Raj C Shah - Rush University Medical Center
Stephanie A Ward - Monash University
Elsdon Storey - Monash University
Mark R Nelson - University of Tasmania
Christopher M Reid - Monash University
Jessica E Lockery - Monash University
Suzanne G Orchard - Monash University
Ruth Trevaks - Monash University
Sharyn M Fitzgerald - Monash University
Nigel P Stocks - The University of Adelaide
Andy Chan - Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
John J McNeil - Monash University
Anne M Murray - Berman Center for Outcomes and Clinical Research
Anne B Newman - University of Pittsburgh
Joanne Ryan - Monash University
Contributors: Lewis A Lipsitz (Editor)
Resource Type: Journal article
Publication Details: The journals of gerontology. Series A, Biological sciences and medical sciences, Vol.77(10), pp.2007-2014
DOI: 10.1093/gerona/glab340
PMID: 34758073
PMCID: PMC9536436
NLM abbreviation: J Gerontol A Biol Sci Med Sci
ISSN: 1079-5006
eISSN: 1758-535X
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000054, name: National Cancer Institute, award: U01AG029824; DOI: 10.13039/501100000925, name: National Health and Medical Research Council, award: 334047, 1127060; DOI: 10.13039/501100001779, name: Monash University; DOI: 10.13039/100008018, name: Victorian Cancer Agency; name: San Antonio Claude D. Pepper Older Americans Independence Center, award: P30 AG044271; DOI: 10.13039/100000049, name: National Institute on Aging, award: R01 AG052697, R01 AG069690
Language: English
Electronic publication date: 11/10/2021
Date published: 10/2022
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9984297550202771

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