Evidence map›Paper›PMID 35393614›Full record

Trial reportEuropean heart journal2022

Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial.

Sarah Parish, Marion Mafham, Alison Offer, Jill Barton, Karl Wallendszus, William Stevens, Georgina Buck, Richard Haynes, Rory Collins, Louise Bowman and 1 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00135226 (A Study of Cardiovascular Events iN Diabetes - A Randomized 2x2 Factorial Study of Aspirin Versus Placebo, and of Omega-3 Fatty Acid Supplementation Versus Placebo, for Primary Prevention of Cardiovascular Events in People With Diabetes), which is not on this map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00135226 phase4active not recruitingnot on this map

A Study of Cardiovascular Events iN Diabetes - A Randomized 2x2 Factorial Study of Aspirin Versus Placebo, and of Omega-3 Fatty Acid Supplementation Versus Placebo, for Primary Prevention of Cardiovascular Events in People With Diabetes

TypeinterventionalSponsorUniversity of OxfordRan2005 to 2037Enrolled15,480ConditionsDiabetes MellitusArmsAspirin, Omega-3 Ethyl Esters, Placebo Aspirin, Placebo Omega-3 Ethyl Esters
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Diabetes-Associated Cognitive Impairment: Pathophysiology and Emerging Therapies.Annals of clinical and translational neurology · 2026
    Review
  7. Review
  8. Article
  9. Observational
  10. Review
  11. Review
  12. Article
  13. Article
  14. Vascular cognitive impairment and dementia: Mechanisms, treatment, and future directions.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
  15. Review
  16. Embedding routine health care data in clinical trials: with great power comes great responsibility.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024
    Review
  17. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Sarah ParishMRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK.ORCID 0000-0003-3532-0832
Marion MafhamClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0003-0562-3963
Alison OfferClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-3367-3207
Jill BartonClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-6534-6307
Karl WallendszusClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0003-0971-3026
William StevensClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0001-8474-4645
Georgina BuckClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0001-5909-4265
Richard HaynesClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-1179-0023
Rory CollinsClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0001-8288-8602
Louise BowmanMRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK.ORCID 0000-0003-1125-8616
Jane ArmitageMRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK.ORCID 0000-0001-8691-9226
University of Oxford · GB

Funding

British Heart Foundation CH/1996001/9454British Heart Foundation SP/03/002British Heart Foundation SP/08/010/25939British Heart Foundation SP/14/3/31114Cancer Research UKMedical Research Council G0300622Medical Research Council MC_EX_G0801669Medical Research Council MC_PC_12027Medical Research Council MC_PC_12028Medical Research Council MC_PC_12029Medical Research Council MC_PC_15067Medical Research Council MC_U137686854Medical Research Council MC-UU_00017/3Medical Research Council MC-UU_00017/5Medical Research Council MC_UU_12026/5
6 · The paper itself

Abstract

aimsAspirin is widely used in cardiovascular disease prevention but is also associated with an increased risk of bleeding. The net effect of aspirin on dementia and cognitive impairment is uncertain. METHODS AND

resultsIn the ASCEND trial, 15 480 people from the UK with diabetes and no history of cardiovascular disease were randomized to aspirin 100 mg daily or matching placebo for a mean of 7.4 years. The 15 427 ASCEND participants with no recorded dementia prior to baseline were included in this cognitive study with a primary pre-specified outcome of 'broad dementia', comprising dementia, cognitive impairment, or confusion. This was ascertained through participant, carer, or general practitioner report or hospital admission diagnosis, by 31 March 2019 (∼2 years beyond the scheduled treatment period). The broad dementia outcome occurred in a similar percentage of participants in the aspirin group and placebo group: 548 participants (7.1%) vs. 598 (7.8%), rate ratio 0.91 [95% confidence interval (CI), 0.81-1.02]. Thus, the CI excluded proportional hazards of >2% and proportional benefits of >19%.

conclusionAspirin does not have a large proportional effect on the risk of dementia. Trials or meta-analyses with larger total numbers of incident dementia cases to increase statistical power are needed to assess whether any modest proportional 10-15% benefits of 5-7 years of aspirin use on dementia exist. CLINICAL

trial registrationCurrent Controlled Trials number, ISRCTN60635500; ClinicalTrials.gov number: NCT00135226.

Indexed as

Cognitive DysfunctionDementiaDiabetes MellitusAspirinCognitionHumansAspirinAspirinCardiovascular diseaseDementia

Identifiers

PMID35393614
PMCPMC9242621
OpenAlexW4226446021

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.