A new analysis from Monash University suggests that a low dose of aspirin could be linked to a significantly lower risk of dementia in older people with certain genetic characteristics. Researchers found that people with a specific genetic profile who took aspirin had a 70 percent lower relative risk of developing dementia, suggesting that genetic testing could potentially help identify people who might benefit from preventative treatments.
The results, published in Alzheimer and dementia: the journal of the Alzheimer Associationwere based on genetic data from more than 13,500 participants in the landmark ASPREE (Aspirin in Reducing Events in the Elderly) trial. The scientists examined whether differences in participants’ genes could help explain why aspirin might affect dementia risk differently across people.
Aspirin linked to 70% reduced risk of dementia in some people
The most striking results were for genes associated with platelet counts. Platelets are small components of the blood that contribute to the formation of clots, and the researchers wanted to determine whether genetic variations linked to platelet levels could influence the potential effects of aspirin on dementia.
After assigning participants genetic scores associated with platelet counts, the team compared dementia rates among those who received aspirin and those who received a placebo.
Among people with the highest 20 percent genetic scores for platelet counts, only 1 percent of aspirin users developed dementia, compared with 3.3 percent of participants taking a placebo. This difference translates into an approximately 70% lower relative risk of dementia among people receiving aspirin.
However, the apparent advantage came with a significant security concern. In the same genetic group, 4.4 percent of aspirin users experienced major bleeding, compared to 2.1 percent of those receiving a placebo.
Genetic clue could change dementia prevention
Lead author Dr Peter Fransquet, a researcher at Monash’s School of Public Health and Preventative Medicine, said the findings suggest a person’s genetic makeup could potentially play an important role in determining the most appropriate dementia prevention strategies.
“Previous trials showed that aspirin did not prevent dementia when everyone was considered together,” Dr. Fransquet said.
“Our results suggest that there may be more to it.
“In people with this particular genetic profile, we observed significantly fewer cases of dementia among those who took aspirin.
“This raises the possibility that genetics could one day help us identify people who might benefit from preventative treatment, rather than taking a one-size-fits-all approach.”
The opportunity for more targeted prevention is particularly important as dementia becomes more common. Dementia Australia estimates that around 446,500 people in Australia are living with the disease in 2026. This number is expected to exceed one million by 2065.
Blood platelets reveal unexpected link to dementia
Previous research has linked dementia to platelet activation and aggregation, processes by which platelets become active and stick together. However, scientists have a less complete understanding of the link between a person’s overall platelet count and dementia.
The new findings point to platelet biology as a potentially important area of investigation. Notably, the genetic association identified by the researchers did not involve the well-established genetic risk factors typically linked to Alzheimer’s disease and other forms of dementia.
“What is particularly interesting is that the signal was not linked to established genetic risk factors for Alzheimer’s disease and dementia,” Dr. Fransquet said.
“Instead, it points us toward platelet biology and gives us a new avenue to explore.”
Why more research is needed before taking aspirin
Although the results suggest that aspirin might have different effects depending on a person’s genes, the researchers stress that the results need to be confirmed before medical recommendations can be guided.
The next step is to investigate whether the association appears in other populations. Scientists should then conduct a clinical trial specifically involving people with the genetic profile identified during the analysis.
“We now need to confirm the results in other studies and ultimately test them in a trial designed specifically for people with this genetic profile.
“Based on this study, people should not start taking aspirin to prevent dementia without consulting their doctor, especially given the increased risk of serious bleeding.
“If this persists, the fact that aspirin is already cheap and widely available could make personalized dementia prevention a real possibility.”
Gn Health
