Daily low-dose aspirin did not protect function in 18,581 older adults, and women declined slightly faster

Investigators led from Monash University re-analyzed a randomized trial that compared daily 100 mg aspirin with placebo in community-dwelling adults aged 65 and older. They built an intrinsic capacity (IC) score covering cognition, locomotion, vitality and psychological well-being, calculated it every year in 18,581 participants, and checked it against biological and clinical measures.

What they found

IC correlated with chronological age (r = -0.30), with a deficit-accumulation index (r = -0.56 in women and -0.54 in men) and with epigenetic clocks such as PC-PhenoAge, PC-GrimAge and DunedinPACE, particularly in women. People in the lowest IC quintile at baseline had roughly four- to nearly five-fold higher hazard of losing dementia- and disability-free survival than those in the highest quintile. Women randomized to aspirin had a small but statistically significant faster IC decline (beta -0.006; 95% CI -0.01 to -0.001; p = 0.01). No effect was seen in men (p = 0.86).

The nuance

This was a post hoc analysis, and the formal test of whether the aspirin effect differed by sex was borderline (p = 0.06). The extra decline in women was very small. The finding still deserves attention because it comes from a randomized comparison rather than an observational one.

Youthful take

Low-dose aspirin is not a healthspan drug for healthy older adults. Aspirin has specific medical uses that your physician may recommend, so do not start or stop it on your own. The bigger takeaway is that intrinsic capacity, a practical measure of how well you function, may become a useful way to track healthy aging.