Genetic profile may determine who benefits from aspirin against dementia

A new analysis by researchers at Monash University found that low-dose aspirin was associated with a 70% lower risk of dementia among older adults with a particular genetic profile. The findings suggest that genetic factors may influence who could potentially benefit from aspirin as a preventive treatment.

According to EurekAlert, the researchers analyzed genetic data from the ASPREE (Aspirin in Reducing Events in the Elderly) trial. They examined genetic scores from more than 13,500 participants to determine whether individuals’ genetic characteristics influenced the effect of aspirin on dementia risk.

The strongest finding was linked to genetic factors affecting platelet count. The researchers ranked participants according to their genetic scores associated with platelet count.

Among participants in the top 20% for the platelet-count genetic score, dementia occurred in just 1% of those taking aspirin, compared with 3.3% of those receiving a placebo. This corresponded to an approximately 70% lower relative risk associated with aspirin use.

However, aspirin was also associated with an increased risk of major bleeding in this group. Major bleeding occurred in 4.4% of aspirin users, compared with 2.1% of those receiving a placebo.

Dr. Peter Fransquet, one of the researchers involved in the study, said the findings could open the door to a more personalized approach to dementia prevention.

“Previous trials showed that when everyone was considered together, it was not clear that aspirin prevented dementia,” Fransquet said. “Our findings suggest that the picture may be more complex. Among people with these specific genetic characteristics, dementia cases were substantially lower among those taking aspirin.”

He said the findings raise the possibility that genetics could eventually help identify people who may benefit from preventive treatment rather than applying the same approach to everyone.

Although scientists have previously identified links between platelet activation and aggregation and dementia, the role of overall platelet count has been less clear.

“What is particularly interesting is that this signal was not associated with known genetic risk factors for Alzheimer’s disease and dementia,” Fransquet said. “Instead, it directs our attention toward platelet biology and opens a new avenue for research.”

He added that the finding needs to be replicated in other studies and ultimately tested in a clinical trial specifically designed for people with this genetic profile.

Fransquet also cautioned that people should not start taking aspirin to prevent dementia solely on the basis of the findings and without consulting their doctors, particularly given the increased risk of major bleeding.

“If these findings are confirmed, the low cost and widespread availability of aspirin could make personalized dementia prevention a practical possibility,” he said.