In the Journals

Low-dose aspirin fails to lower dementia risk among all adults with type 2 diabetes, but may benefit women

Japanese adults with type 2 diabetes assigned a long-term low-dose aspirin regimen did not lower their risk for dementia vs. similar adults who did not routinely take aspirin, according to a post hoc analysis of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes trial.

Takeshi Morimoto

However, researchers observed a reduced risk for dementia among the women with type 2 diabetes who took aspirin vs. women who did not, according to findings published in Diabetes Care.

“The current pharmacological intervention for dementia is just alleviating the progress of dementia,” Takeshi Morimoto, MD, PhD, MPH, professor of medicine in the department of clinical epidemiology at the Hyogo College of Medicine in Hyogo, Japan, told Endocrine Today. “This study is the first clinical trial which attested the prevention of dementia with a drug.”

Morimoto and colleagues identified cases of dementia between 2008 and 2017 in a cohort of 2,536 participants (mean age, 65 years; 45.3% women) from the JPAD study. The researchers randomly assigned a regimen of 81 mg or 100 mg aspirin or no aspirin to adults with type 2 diabetes in the original trial. Median follow-up was 11.4 years.

Women in the entire cohort experienced 6.5 cases of dementia per 1,000 person-years vs. 4.5 cases of dementia per 1,000 person-years among men (P < .001). Women with type 2 diabetes in the aspirin group had a 42% lower risk for dementia compared with women who did not take aspirin (HR = 0.58; 95% CI, 0.36-0.95).

“Our study, therefore, could provide some important leads in the prevention of dementia,” the researchers wrote.

The researchers noted that no differences in dementia development were observed among men who took aspirin and men who did not.

“Low-dose aspirin has potential to reduce the risk of dementia, but the universal use of low-dose aspirin for dementia prevention is too early to be standard therapy,” Morimoto said. “We need further cumulative evidence to justify the use of low-dose aspirin for dementia prevention and to elucidate the appropriate use of low-dose aspirin.” – by Phil Neuffer

For more information:

Takeshi Morimoto, MD, PhD, MPH, can be reached at Hyogo College of Medicine 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan; email: morimoto@kuhp.kyoto-u.ac.jp.

Disclosures: Morimoto reports he has received a research grant from Nexis, lecturer’s fees from AbbVie, AstraZeneca, Daiichi Sankyo, Kyorin, Mitsubishi Tanabe and Pfizer, a manuscript fee from Pfizer and served on the advisory board of Asahi Kasei, Boston Scientific and Bristol-Myers Squibb. Please see the study for all other authors’ relevant financial disclosures. 

Japanese adults with type 2 diabetes assigned a long-term low-dose aspirin regimen did not lower their risk for dementia vs. similar adults who did not routinely take aspirin, according to a post hoc analysis of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes trial.

Takeshi Morimoto

However, researchers observed a reduced risk for dementia among the women with type 2 diabetes who took aspirin vs. women who did not, according to findings published in Diabetes Care.

“The current pharmacological intervention for dementia is just alleviating the progress of dementia,” Takeshi Morimoto, MD, PhD, MPH, professor of medicine in the department of clinical epidemiology at the Hyogo College of Medicine in Hyogo, Japan, told Endocrine Today. “This study is the first clinical trial which attested the prevention of dementia with a drug.”

Morimoto and colleagues identified cases of dementia between 2008 and 2017 in a cohort of 2,536 participants (mean age, 65 years; 45.3% women) from the JPAD study. The researchers randomly assigned a regimen of 81 mg or 100 mg aspirin or no aspirin to adults with type 2 diabetes in the original trial. Median follow-up was 11.4 years.

Women in the entire cohort experienced 6.5 cases of dementia per 1,000 person-years vs. 4.5 cases of dementia per 1,000 person-years among men (P < .001). Women with type 2 diabetes in the aspirin group had a 42% lower risk for dementia compared with women who did not take aspirin (HR = 0.58; 95% CI, 0.36-0.95).

“Our study, therefore, could provide some important leads in the prevention of dementia,” the researchers wrote.

The researchers noted that no differences in dementia development were observed among men who took aspirin and men who did not.

“Low-dose aspirin has potential to reduce the risk of dementia, but the universal use of low-dose aspirin for dementia prevention is too early to be standard therapy,” Morimoto said. “We need further cumulative evidence to justify the use of low-dose aspirin for dementia prevention and to elucidate the appropriate use of low-dose aspirin.” – by Phil Neuffer

For more information:

Takeshi Morimoto, MD, PhD, MPH, can be reached at Hyogo College of Medicine 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan; email: morimoto@kuhp.kyoto-u.ac.jp.

Disclosures: Morimoto reports he has received a research grant from Nexis, lecturer’s fees from AbbVie, AstraZeneca, Daiichi Sankyo, Kyorin, Mitsubishi Tanabe and Pfizer, a manuscript fee from Pfizer and served on the advisory board of Asahi Kasei, Boston Scientific and Bristol-Myers Squibb. Please see the study for all other authors’ relevant financial disclosures.