University of Tasmania

File(s) under permanent embargo

The Effect of Low-Dose Aspirin on Frailty Phenotype and Frailty Index in Community-Dwelling Older Adults in the ASPirin in Reducing Events in the Elderly Study

journal contribution
posted on 2023-05-21, 16:55 authored by Espinoza, SE, Woods, RL, Ekram, ARMS, Ernst, ME, Polekhina, G, Wolfe, R, Shah, RC, Ward, SA, Storey, E, Mark NelsonMark Nelson, Reid, CM, Lockery, JE, Orchard, SG, Trevaks, R, Fitzgerald, SM, Stocks, NP, Chan, A, McNeil, JJ, Murray, AM, Newman, AB, Ryan, J

Background: Frailty is associated with chronic inflammation, which may be modified by aspirin. The purpose of this study was to determine whether low-dose aspirin reduces incident frailty in healthy older adult participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial.

Methods: In the United States and Australia, 19 114 community-dwelling individuals aged ≥70 and older (U.S. minorities ≥65 years) and free of overt cardiovascular disease, persistent physical disability, and dementia were enrolled in ASPREE, a double-blind, placebo-controlled trial of 100-mg daily aspirin versus placebo. Frailty, a prespecified study end point, was defined according to a modified Fried frailty definition (Fried frailty) and the frailty index based on the deficit accumulation model (frailty index). Competing risk Cox proportional hazard models were used to compare time to incident frailty by aspirin versus placebo. Sensitivity analysis was conducted to include frailty data with and without imputation of missing data.

Results: Over a median 4.7 years, 2 252 participants developed incident Fried frailty, and 4 451 had incident frailty according to the frailty index. Compared with placebo, aspirin treatment did not alter the risk of incident frailty (Fried frailty hazard ratio [HR]: 1.04, 95% confidence interval [CI] 0.96-1.13; frailty index HR: 1.03, 95% CI 0.97-1.09). The proportion of individuals classified as frail, and the trajectory in continuous frailty scores over time, were not different between the aspirin and placebo treatment groups. The results were consistent across a series of subgroups.

Conclusions: Low-dose aspirin use in healthy older adults when initiated in older ages does not reduce risk of incident frailty or the trajectory of frailty.


Publication title

The journals of gerontology. Series A, Biological sciences and medical sciences










Tasmanian School of Medicine


Gerontological Society Amer

Place of publication

1275 K Street Nw Suite 350, Washington, USA, Dc, 20005-4006

Rights statement

This work is written by (a) US Government employee(s) and is in the public domain in the US.

Repository Status

  • Restricted

Socio-economic Objectives

Health related to ageing

Usage metrics

    University Of Tasmania


    Ref. manager