Low-dose aspirin fails to reduce the risk of fractures while
increasing the risk of serious falls in older people according to a recent
study published in the JAMA Internal medicine.
Falls and fractures are frequent and deleterious to the
health of older people. Aspirin has been reported to reduce bone fragility and
slow bone loss.
A study was conducted to determine if daily low-dose aspirin
(100 mg) reduces the risk of fractures or serious falls (fall-related hospital
presentations) in healthy older men and women.
This substudy of a double-blind, randomized,
placebo-controlled trial studied older adult men and women in 16 major sites
across southeastern Australia. The ASPREE-FRACTURE substudy was conducted as
part of the Australian component of the ASPREE trial. Between 2010 and 2014
healthy (free of cardiovascular disease, dementia or physical disability),
community-dwelling volunteers aged 70 years or older were recruited to
participate in the ASPREE trial. Potentially eligible participants were identified
by medical practitioners and trial personnel and were then sent a letter of
invitation to participate. Interested participants were screened for
suitability. Eligible participants with medical practitioner authorization and
adherent to a 4-week run-in medication trial were randomized. Data were
analyzed from October 17, 2019, to August 31, 2022.
Results:
- In total, 16 703 people with a median (IQR) age
of 74 (72-78) years were recruited, and 9179 (55.0%) were women. - There were 8322 intervention participants and
8381 control participants included in the primary and secondary outcome
analysis of 2865 fractures and 1688 serious falls over the median follow-up of
4.6 years. - While there was no difference in the risk of
first fracture between the intervention and control participants aspirin was
associated with a higher risk of serious falls - Results remained unchanged in analyses that
adjusted for covariates known to influence fracture and fall risk.
In this substudy of a randomized clinical trial, the failure
of low-dose aspirin to reduce the risk of fractures while increasing the risk
of serious falls adds to evidence that this agent provides little favorable
benefit in a healthy, White older adult population.
Reference:
Barker AL, Morello R, Thao LTP, et al. Daily Low-Dose
Aspirin and Risk of Serious Falls and Fractures in Healthy Older People: A
Substudy of the ASPREE Randomized Clinical Trial. JAMA Intern Med. Published
online November 07, 2022. doi:10.1001/jamainternmed.2022.5028