12th April 2005

Media statement

ASPIRIN AND THE RISK OF DEMENTIA

‘ASPIRIN - THE DEVELOPING STORY’
Conference: Council Chamber, Royal College of Physicians

Dementia affects about 775,000 people in the UK - one in 20 people over 65 and one in five of those aged over 80. It is not, however, a disorder confined to older people: 18,000 people with dementia are under 65. As the average age of the population increases, the number of people with dementia will grow steadily and is expected to reach 1.8 million in less than 50 years1.

Just over half (55 percent) of dementia cases are due to Alzheimer's disease (AD). There is growing evidence from epidemiological studies that long-term use of aspirin and some NSAIDs is associated with a lower risk of AD2. Preliminary data from one placebo-controlled prevention study support these findings and, if this is confirmed by further prospective randomised trials, aspirin will play a major role in improving public health in the years to come.

Current evidence on aspirin and the risk of AD will be reviewed at today's Conference, Aspirin - the Developing Story, by Professor Clive Ballard (Director of Research at the Alzheimer's Society). He says, "There are several potential mechanisms whereby aspirin and/or other NSAIDs could be beneficial, including the prophylaxis of concurrent cerebrovascular disease, inhibitory effects on key inflammatory molecules and a direct impact on amyloid processing." Professor Ballard describes the evidence as promising and says more work is needed before drawing firm conclusions.

There is still no conclusive evidence that aspirin reduces the risk of vascular dementia, which accounts for about 20 percent of dementia cases in the UK1, but as secondary prevention it does reduce the risk of stroke3. "It follows that low dose aspirin has an important role to play in preventing progression of cerebrovascular pathology and this is likely to help to preserve cognitive function", comments Dr Tony Bayer (University of Wales College of Medicine) who reviews the role of aspirin in the management of dementia. Dr Bayer adds that most specialists believe that aspirin should be offered to patients with cognitive impairment and vascular risk factors.

References
1. www.alzheimers.org.uk/News_and_Campaigns/Policy_Watch/demography.htm
2. Etminan M, Gill S, Samii A. Br Med J 2003;327:128-3
3. Antithrombotic Trialists' Collaboration. Br Med J 2002;324:71-86