Low-Dose Aspirin Cuts Dementia Risk by 70% for People With Specific Genetic Profile
Low-dose aspirin may lower the relative risk of dementia by roughly 70 percent, but only for older adults who carry a specific genetic profile tied to platelet counts, according to research published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
- Researchers analyzed genetic data from roughly 5,000 participants in the landmark ASPREE trial to evaluate aspirin’s effect on cognitive decline.
- Participants in the top 20 percent of a genetic score linked to high platelets saw a significant drop in dementia cases, but experienced about twice the rate of major bleeding.
- Study authors emphasize that routine blood counts cannot identify this subgroup, because a high platelet-associated polygenic score is not a measured value from a standard blood test.
Genetic Scores and Platelet Biology Reveal a Subgroup Benefit
For years, clinical investigations into aspirin as a preventive agent for Alzheimer’s disease and related dementias yielded disappointing results. The 2018 ASPREE trial, which examined daily 100-milligram doses of aspirin versus a placebo in healthy older adults, found no significant reduction in dementia, mild cognitive impairment, or cognitive decline. A subsequent analysis of ASPREE data—based on genetic data from around 5,000 participants—examined polygenic scores.
Lead author Dr. Peter Fransquet, a Research Fellow at Monash University’s School of Public Health and Preventive Medicine, said previous trials found aspirin didn’t prevent dementia when everyone was considered together, and that the new findings suggest there may be more to the story. Only 1 percent of aspirin-taking individuals who ranked in the top 20 percent of a genetic score linked to platelet count developed dementia, whereas 3.3 percent of the placebo group experienced the same. Alexander Zubkov, a board-certified neurologist and physician with 1MD Nutrition, explained that this difference represents a relative risk reduction of roughly 70 percent.
Bleeding Risks Offset Cognitive Benefits for the Majority
Despite the steep drop in relative dementia risk for the genetically susceptible cohort, the prevention strategy carried a significant safety caveat. In the exact same high-platelet genetic subgroup, major bleeding events roughly doubled among those taking aspirin. Major bleeding occurred in 4.4 percent of the aspirin users within that group, contrasted with 2.1 percent among participants given a placebo. For the remaining 80 percent of trial participants who did not possess this genetic subtype, low-dose aspirin showed no dementia-prevention benefit.
Luke Sorrell, a board-certified internist in longevity medicine and founder of Sorrell MD, emphasized that routine laboratory work cannot substitute for the specialized DNA scans used in the study. A high platelet-associated polygenic score reflects a person’s genetic tendency for high platelets, not a measured value from a regular blood test.
Complicating Factors and Unresolved Research Questions Regarding Aspirin Use
Risk factors for aspirin-associated bleeding—such as a history of ulcers, kidney disease, uncontrolled hypertension, heavy alcohol use, or concurrent use of blood thinners, NSAIDs, SSRIs, or steroids—continue to complicate regular use.
Researchers suggest that in people with a genetic tendency toward more platelet activity, aspirin might reduce small-vessel damage and the chronic inflammation behind it. However, experts stress that these findings require replication in dedicated clinical trials before altering standard patient care. The observed benefits and harms were essentially equivalent in absolute terms.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.