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Published on: January 4, 2015
by Kathy Evans for The Age:
The properties of aspirin have long been recognised in preventing stroke and heart attack, but the world’s most humble drug could prove to be a secret weapon against one of the worst ravages of old age.
A $50 million medical trial funded by the United States‐based National Institutes of Health is under way in Australia to determine whether this little white pill, used for everything from headaches to hangovers, could also delay the onset of dementia, and prevent certain types of cancers as well as deafness and blindness.
The trial, ASPirin in Reducing Events in the Elderly (ASPREE), is a joint project between Monash University School of Public Health and Preventive Medicine and the Berman Centre for Outcomes and Clinical Research, in Minneapolis, and has recently recruited its 19,000th participant , making it the largest medical trial conducted on these shores.
The study has grown from its initial aim of studying the possible preventive effects of aspirin in the development of heart attacks and stroke, to determining whether aspirin can boost an elderly person’s “disability‐free” years, keeping them active and out of nursing homes for longer.
“Increasingly with the elderly, the important issue is how to keep them as healthy as can be,” Professor John McNeil, the study’s chief investigator in Australia, says. “This has become a priority for medicine.”
Aspirin’s miracle properties revolve around its ability to stop blood platelets clumping together, reducing the risk of heart attacks and strokes. But the active ingredient salicin, originally derived from the willow tree and used in Hippocrates’s time, also has an anti‐inflammatory effect.
This could be beneficial in the elderly who may have low‐grade inflammation in areas of the body such as the eyes, ears, muscles and brain, possibly triggering deafness, blindness and dementia.
“There is a hypothesis that this low‐grade inflammation may be damaging, so one of the things we are looking at is whether low doses of aspirin may be able to suppress this inflamation,” Professor McNeil said.
“Once you have a large-scale study like ASPREE, there is an enormous amount of additional information that you can get,” he said. More than 2000 GPs throughout Australia collaborated in the project, helping recruit patients over 70 for the randomised double‐blind placebo-controlled study.
In a vastly ageing population, “doctors are acutely aware of how important this issue is”.
Alzheimer’s Australia’s chief medical adviser Michael Woodward agreed. “This is an incredibly important study with a number of end points that could prove benificial for survival,” he said.
While there have been smaller, epidemiological studies into the use of aspirin for prevention of dementias, he believes the ASPREE research will shine a light on a bigger, broader picture of cognitive decline.
But for all its wondrous properties, aspirin is by no means a magic bullet. It can cause stomach bleeding, anaemia, and trigger some types of stroke.
Results from the trial won’t be known until 2018 but, says Professor McNeil, “they are likely to guide medical practice for many years into the future”.
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