Evidence map›Paper›PMID 41043446›Full record

Observational studyThe lancet. Healthy longevity2025

Aspirin and healthy lifespan in older people: main outcome of the ASPREE-XT observational study.

Raj C Shah, Joanne Ryan, Katherine L Webb, Rory Wolfe, Andrew Chan, Trevor T-J Chong, Michael E Ernst, Sara E Espinoza, Olivia Flynn, Song Yuin Lee and 10 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The lancet. Healthy longevity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Raj C ShahDepartment of Family and Preventive Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA. Electronic address: raj_c_shah@rush.edu.
Joanne RyanSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Katherine L WebbSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Rory WolfeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Andrew ChanClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Trevor T-J ChongTurner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia; Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, VIC, Australia.
Michael E ErnstDepartment of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA; Department of Family and Community Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA.
Sara E EspinozaCenter for Translational Geroscience, Diabetes and Aging Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Olivia FlynnConcord Hospital, Sydney, NSW, Australia.
Song Yuin LeeDepartment of Geriatrics, Prince of Wales Hospital, Sydney, NSW, Australia; Department of General Medicine, Sutherland Hospital, Sydney, NSW, Australia.
John McNeilSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Mark R NelsonMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Suzanne G OrchardSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Christopher M ReidSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Population Health, Curtin University, Perth, WA, Australia.
Kerry SheetsDepartment of Medicine, Geriatrics Division, Hennepin Healthcare, Minneapolis, MN, USA; Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
Nigel P StocksDiscipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
Nilakshi S WeerasingheDepartment of Aged Care, Bankstown-Lidcombe Hospital Sydney, Bankstown, NSW, Australia; University of New South Wales Southwest Sydney Campus, Sydney, NSW, Australia.
Michelle E WilsonSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Robyn L WoodsSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Anne M MurrayDepartment of Medicine, Geriatrics Division, Hennepin Healthcare, Minneapolis, MN, USA; Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, USA.

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI CHAN, ANDREW T, MCNEIL, JOHN JAMES · 2019 to 2023
$42.9M
NIA NIH HHS U01 AG029824NIA NIH HHS U19 AG062682
6 · The paper itself

Abstract

backgroundIn the Aspirin in Reducing Events in the Elderly (ASPREE) clinical trial, low-dose aspirin was not associated with survival free of dementia and persistent physical disability (a measure of a healthy lifespan); however, there was a small increased risk of death. Given the long pre-clinical phase of many ageing conditions, we aimed to examine the legacy effect (post-trial) and the longer-term effect of aspirin versus placebo through extended follow-up in the ASPREE-XT observational study.

methodsBetween March 10, 2010, and Dec 24, 2014, 19 114 community-dwelling people in Australia and the USA, aged predominantly 70 years and older, were randomly assigned to low-dose aspirin or placebo for a median of 4·7 years as part of the ASPREE trial. Post-trial observational follow-up continued for a median of 4·3 years (IQR 4·1-4·6). All components of the primary endpoint (ie, incident dementia, persistent physical disability, and death) were adjudicated by masked expert panels. Analyses used Cox proportional hazards models with intention-to-treat.

findings15 633 participants (8836 [56·5%] were women, 6797 [43·5%] were men; 981 [6·3%] were not White) were eligible for and agreed to observational follow-up. There was no effect of randomisation to aspirin (34·37 events per 1000 person-years) versus placebo (33·68 per 1000 person-years) on the primary endpoint (hazard ratio [HR] 1·02; 95% CI 0·94-1·11; p=0·63) in the ASPREE-XT period. Similarly, over the period of both ASPREE and ASPREE-XT, no long-term effect of aspirin versus placebo was observed on the composite outcome of death, dementia, or persistent physical disability over almost a decade of follow-up (HR 1·01; 95% CI 0·95-1·08; p=0·65), including no long-term effect on deaths (1·06; 0·99-1·14; p=0·10). No effect of aspirin on incident major haemorrhagic events as compared with placebo was found in ASPREE-XT; however, aspirin was associated with an increased hazard for incident major haemorrhagic events across both ASPREE and ASPREE-XT (1·24; 1·10-1·39).

interpretationLow-dose aspirin does not appear to be effective in promoting a healthy lifespan in initially healthy, community-dwelling older people.

fundingNational Institute on Aging and the National Cancer Institute (USA).

Indexed as

AspirinLongevityAgedAged, 80 and overAustraliaDementiaFemaleHumansMaleProportional Hazards ModelsRandomized Controlled Trials as TopicUnited StatesAspirin

Identifiers

PMID41043446
PMCPMC12551462

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.