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Aspirin (low dose)

  • Drugs
  • Updated July 8, 2025

Aspirin is an anti-inflammatory drug primarily used to relieve pain, fevers, and inflammation. It also has anti-clotting properties and has been widely used to prevent adverse cardiovascular events. Guidance has shifted in recent years to reflect updated evidence that the preventative benefits of low-dose aspirin do not outweigh the risk for bleeding in healthy older populations at low to moderate cardiovascular risk. Similarly, the potential effects on dementia prevention appear to be limited to those at high cardiovascular risk. 

Evidence

Aspirin has been tested in numerous high-quality, large-scale studies. Most meta-analyses of clinical trials and observational studies find no association between aspirin use and dementia risk, though some subpopulations may benefit. Our search identified:

  • 1 Cochrane meta-analysis of 3 randomized controlled trials
  • 3 meta-analyses of randomized controlled trials and cohort studies
  • 1 meta-analysis of cohort studies with long follow-ups
  • 2 meta-analyses of observational studies plus 7 subsequent cohort studies
  • 3 randomized controlled trials assessing low-dose aspirin in dementia prevention
  • 2 randomized controlled trials assessing low-dose aspirin for cerebrovascular disease

Potential Benefit

Most studies have found that aspirin use does not meaningfully impact cognition and dementia risk in the general population [1; 2; 3; 4]. However, aspirin use has been linked with lower dementia risk in particular subpopulations. Evidence from two large cohort studies found that aspirin use was associated with meaningfully lower dementia risk in participants with coronary heart disease [5]. Protection from dementia was also observed in a trial including participants at high risk for cardiovascular disease [6]. Notably, risk reduction was only observed when aspirin was used for at least ten years. Some studies may have been too short to detect an effect on cognitive or dementia outcomes. Of the three large, long-term prevention trials for low-dose aspirin assessing cognitive outcomes, a potential benefit in women was only observed in the study with a follow-up longer than ten years [6; 7; 8]. Additionally, low-dose aspirin did not protect against stroke-related cognitive impairment in clinical studies [9; 10].

Overall, a low-dose aspirin regimen may help reduce dementia risk in individuals with cardiovascular disease or at high risk, but is unlikely to benefit other populations.

For Dementia Patients

One observational study found that aspirin use was associated with a lower rate of cognitive decline in male patients with Alzheimer’s disease [11]. However, clinical trials with aspirin have not shown benefits on cognition or disease progression [12]. 

Safety

The primary safety risk associated with aspirin is bleeding, particularly in the gastrointestinal tract [13]. This risk increases with age, particularly in those over age 65, and is higher in men [14]. Due to the bleeding risk, aspirin has interactions with other blood thinner medications, as well as some herbal medicines, such as ginkgo, ginger, and ginseng [15]. Consuming alcohol also increases the risk of bleeding.

NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.

How to Use

Low dose aspirin is defined as doses between 75 to 100 mg/day. While most clinical trials have tested aspirin at a dose of 100 mg/day, the most common over the counter formulation is an oral tablet containing 81 mg of aspirin. The guidelines for use vary with age, bleeding risk, and cardiovascular risk [16]. It is not recommended for primary prevention in adults over age 70, but may be considered on an individualized basis for adults aged 40 to 70 at low bleeding risk and very high cardiovascular risk [17]. 

Learn More

Full scientific report (PDF) on Cognitive Vitality Reports 

For more information on the history, use, and safety see Drugs.com 

References

  1. Tao T, Feng G, Fang Y (2024) Association between aspirin use and risk of dementia: a systematic review and meta-analysis. European geriatric medicine 15, 3-18
  2. Veronese N, Stubbs B, Maggi S et al. (2017) Low-Dose Aspirin Use and Cognitive Function in Older Age: A Systematic Review and Meta-analysis. Journal of the American Geriatrics Society 65, 1763-1768
  3. Kang JH, Cook N, Manson J et al. (2007) Low dose aspirin and cognitive function in the women's health study cognitive cohort. Bmj 334, 987
  4. Li H, Li W, Zhang X et al. (2020) Aspirin Use on Incident Dementia and Mild Cognitive Decline: A Systematic Review and Meta-Analysis. Frontiers in aging neuroscience 12, 578071
  5. Nguyen TNM, Chen LJ, Trares K et al. (2022) Long-term low-dose acetylsalicylic use shows protective potential for the development of both vascular dementia and Alzheimer's disease in patients with coronary heart disease but not in other individuals from the general population: Results from two large cohort studies. Alzheimer's research & therapy 14, 75
  6. Matsumoto C, Ogawa H, Saito Y et al. (2020) Sex difference in effects of low-dose aspirin on prevention of dementia in patients with type 2 diabetes: A long-term follow-up study of a randomized clinical trial. Diabetes care 43, 314-320
  7. Ryan J, Storey E, Murray AM et al. (2020) Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline. Neurology 95, e320-e331
  8. Parish S, Mafham M, Offer A et al. (2022) Effects of aspirin on dementia and cognitive function in diabetic patients: The ASCEND trial. European heart journal 43, 2010-2019
  9. Kim BC, Youn YC, Jeong JH et al. (2022) Cilostazol versus aspirin on white matter changes in cerebral small vessel disease: A randomized controlled trial. Stroke; a journal of cerebral circulation 53, 698-709
  10. Maestrini I, Altieri M, Di Clemente L et al. (2018) Longitudinal study on low-dose aspirin versus placebo administration in silent brain infarcts: The silence study. Stroke research and treatment 2018, 7532403
  11. Weng J, Zhao G, Weng L et al. (2021) Aspirin use was associated with slower cognitive decline in patients with Alzheimer's disease. PloS one 16, e0252969
  12. Jaturapatporn D, Isaac MG, McCleery J et al. (2012) Aspirin, steroidal and non-steroidal anti-inflammatory drugs for the treatment of Alzheimer's disease. CochraneDatabaseSystRev 2:CD006378., CD006378
  13. Lin MH, Lee CH, Lin C et al. (2019) Low-Dose Aspirin for the Primary Prevention of Cardiovascular Disease in Diabetic Individuals: A Meta-Analysis of Randomized Control Trials and Trial Sequential Analysis. Journal of clinical medicine 8
  14. U.S. Preventive Services Task Force (2009) Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Annals of internal medicine 150, 396-404
  15. NHS inform (2024) Aspirin
  16. US Preventive Services Task Force (2022) Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. Jama 327, 1577-1584
  17. Arnett DK, Blumenthal RS, Albert MA et al. (2019) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 140, e596-e646