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A Monash University analysis of more than 13,500 ASPREE participants found that, among people in the highest 20% of genetic scores associated with platelet count, dementia occurred in 1% of aspirin users and 3.3% of placebo users. Major bleeding was also more common in that aspirin group, and the researchers say the finding needs confirmation and a dedicated trial before it can guide treatment.
A Monash University analysis of genetic data from more than 13,500 participants in the ASPREE trial found that low-dose aspirin was associated with a lower dementia rate in one genetic subgroup of older adults—but major bleeding was more frequent among aspirin users in that group. The result is a subgroup finding, not evidence that people should take aspirin to prevent dementia, and researchers say it needs independent confirmation and a dedicated clinical trial.
Researchers compared dementia rates among participants assigned aspirin or placebo, grouping them by genetic scores associated with platelet count. In the highest 20% of platelet-count genetic scores, dementia was recorded in 1% of aspirin users and 3.3% of participants given placebo. The researchers described this as about a 70% lower relative risk in that subgroup. The figures are observed rates from the analysis; they do not show that aspirin would produce the same result for people outside that genetic group.
The apparent difference came with a safety concern. In the same subgroup, major bleeding occurred in 4.4% of aspirin users, compared with 2.1% of placebo recipients. The analysis therefore found both a lower dementia rate and a higher major-bleeding rate among aspirin users with the relevant genetic scores. It does not establish that the potential dementia benefit outweighs the bleeding risk for an individual.
The findings were published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association and drew on the landmark ASPREE (Aspirin in Reducing Events in the Elderly) trial. The new work examined whether genetic differences could help explain why aspirin’s effects on dementia might vary among participants, rather than treating the trial population as a single group.
A Possible Route to Targeted Prevention
The analysis raises the possibility that genetic information could help identify differences in response to a potential prevention strategy. Earlier trials considered aspirin’s effect across participants overall and did not find that it prevented dementia for the group as a whole, according to lead author Dr. Peter Fransquet. A subgroup signal could help researchers frame new questions, but it does not establish a treatment recommendation.
The potential relevance is broad because dementia affects many people and its prevalence is expected to grow. Dementia Australia estimates that about 446,500 people in Australia are living with dementia in 2026, with the number projected to exceed one million by 2065. Those figures help explain interest in prevention research, but they do not change the study’s central limitation: the observed association must be replicated, and any possible benefit must be weighed against serious bleeding.
For readers, the immediate practical point is caution. The result is not a reason to start aspirin for dementia prevention. Aspirin can cause major bleeding, and decisions about taking it should be discussed with a clinician who can consider a person’s health and existing medications.
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What ASPREE Data Can Show
ASPREE was a large trial of aspirin in older adults. In this analysis, researchers used genetic information from more than 13,500 participants to explore whether inherited differences related to platelet count might affect the relationship between aspirin and dementia. Participants in the analysis had been assigned aspirin or placebo, allowing the team to compare dementia rates between the groups.
Platelets are blood components involved in clotting. Previous research has linked platelet activation and aggregation—the processes by which platelets become active and stick together—with dementia, but the role of overall platelet count has been less clear. The new analysis points to platelet biology as a possible avenue for investigation; it does not explain a mechanism or prove that the genetic score itself causes differences in dementia risk.
Fransquet said the signal was not associated with the established genetic risk factors typically linked to Alzheimer’s disease and dementia. That finding makes the platelet-related result an additional research lead, rather than a replacement for known risk factors or a validated method for selecting treatment.
“In people with this particular genetic profile, we saw substantially fewer cases of dementia among those taking aspirin.”
— Dr. Peter Fransquet
The Bleeding Risk and Open Questions
The study reports a subgroup association; it does not show that aspirin caused the lower dementia rate in this genetic group or explain why the difference appeared. The supplied findings do not establish whether the result will hold in other populations, whether the genetic score can reliably identify people who might benefit, or how a possible dementia benefit should be balanced against bleeding for an individual.
The size of the subgroup and the broader clinical details needed to judge how well the result applies to different patients are not specified in the report summary. It is also not clear from the reported figures how the association would translate into an individual’s absolute likelihood of benefit. The higher rate of major bleeding is a direct safety concern, not a detail that can be set aside because dementia rates were lower in the analysis.
Most importantly, the finding does not support people taking aspirin on their own for dementia prevention. Researchers say the association needs replication and a trial designed for participants with the genetic profile before it can inform recommendations.
Replication Before Any Trial Advice
The research team says the next step is to check whether the association appears in other studies and populations. If the result holds up, researchers would then need to conduct a clinical trial specifically involving people with the identified genetic profile. Such a trial could test whether aspirin changes dementia outcomes in that group and assess the balance of possible benefit against major bleeding.
Until those steps are completed, the result remains a research finding rather than a new prevention strategy. People considering aspirin should speak with a doctor, particularly because the study found more major bleeding among aspirin users in the subgroup. Whether genetic testing could eventually guide prevention decisions also remains an open question.
Key Questions
Does this study show that aspirin prevents dementia?
No. It found that dementia was less common among aspirin users in one genetic subgroup in an analysis of ASPREE data. The researchers say the association needs confirmation and testing in a clinical trial designed for that group.
What does the 70% figure refer to?
It is the reported relative risk reduction based on dementia rates of 1% among aspirin users and 3.3% among placebo recipients in the highest 20% of platelet-count genetic scores. It applies to that subgroup, not to all older adults.
What was the safety concern?
In the same genetic subgroup, major bleeding occurred in 4.4% of aspirin users and 2.1% of placebo recipients. The study does not establish that a possible dementia benefit outweighs that risk for any particular person.
Should I take aspirin to lower my dementia risk?
The researchers advise against starting aspirin for dementia prevention based on this analysis. Speak with a doctor before taking aspirin, especially because of the risk of serious bleeding.
What research is needed next?
The association needs to be checked in other studies and populations. Researchers say a clinical trial specifically enrolling people with the genetic profile would be needed before the result could guide prevention advice.
Source: rss
