Effect of aspirin use on conversion risk from mild cognitive impairment to Alzheimer’s disease

Topic: Amyloid, tau and blood-test diagnosis

The data of 508,107 individuals were analyzed (mean [standard deviation] age, 67.6 [10.7] years; 66.8% women and 33.2% men), and 39,318 developed Alzheimer's disease (22,572 controls and 16,746 using aspirin). The rate of conversion to Alzheimer's disease was lower in the aspirin user group, and the time to Alzheimer's disease dementia occurrence was longer than in the nonuser group. A decreased Alzheimer's disease dementia risk was found in patients using aspirin in Model 2 (adjusted hazard ratio, 0.939; 95% confidence interval, 0.920-0.959), with more pronounced effects in individuals aged ≥65 years (Model 2 adjusted hazard ratio, 0.934; 95% confidence interval, 0.914-0.955). For hemorrhagic stroke, the risk increased with aspirin use across all age groups, with the highest risk observed in younger patients (Model 2 adjusted hazard ratio, 5.082; 95% confidence interval, 4.838-5.338). Aspirin use was associated with reduced Alzheimer's disease risk in older patients with mild cognitive impairment. Notably, the bleeding risk associated with aspirin use should be considered, and personalized treatment should be provided.

Key findings

• The data of 508,107 individuals were analyzed (mean [standard deviation] age, 67.6 [10.7] years; 66.8% women and 33.2% men), and 39,318 developed Alzheimer's disease (22,572 controls and 16,746 using aspirin).
• The rate of conversion to Alzheimer's disease was lower in the aspirin user group, and the time to Alzheimer's disease dementia occurrence was longer than in the nonuser group.
• A decreased Alzheimer's disease dementia risk was found in patients using aspirin in Model 2 (adjusted hazard ratio, 0.939; 95% confidence interval, 0.920-0.959), with more pronounced effects in individuals aged ≥65 years (Model 2 adjusted hazard ratio, 0.934; 95% confidence interval, 0.914-0.955).
• For hemorrhagic stroke, the risk increased with aspirin use across all age groups, with the highest risk observed in younger patients (Model 2 adjusted hazard ratio, 5.082; 95% confidence interval, 4.838-5.338).
• Aspirin use was associated with reduced Alzheimer's disease risk in older patients with mild cognitive impairment.

Why it matters

This cohort study found that aspirin use was associated with a reduced risk of conversion from mild cognitive impairment to Alzheimer's disease, but also with an increased risk of hemorrhagic stroke. It suggests a possible association but does not establish that aspirin prevents Alzheimer's disease, and the bleeding risk must be considered.

Study details

• Study designcohort study
• Participants508,107
• Effect size66.8%; 33.2%
• Evidence strengthModerate

Read the original

• DOI: 10.3389/fnagi.2025.1603892
• PubMed: 40842647
• Original source →
• Free full text: Frontiers in Aging Neuroscience →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{choi2025-40842647,
  author  = {Choi, Bo Kyu and Jin, Yeonju and Lee, Hokyung and Kim, Sung-Woo and Park, Sojeong and Hong, Ickpyo and Baek, Min Seok},
  title   = {{Effect of aspirin use on conversion risk from mild cognitive impairment to Alzheimer’s disease}},
  journal = {Frontiers in Aging Neuroscience},
  year    = {2025},
  doi     = {10.3389/fnagi.2025.1603892},
  pmid    = {40842647},
  url     = {https://doi.org/10.3389/fnagi.2025.1603892}
}

Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Rate of progression of mild cognitive impairment to dementia--meta-analysis of 41 robust inception cohort studies Acta psychiatrica Scandinavica · 2008-02-18 · usefulness score 71/100 · How common it is
• Study design of ASPirin in Reducing Events in the Elderly (ASPREE): a randomized, controlled trial Contemporary clinical trials · 2013-10-07 · usefulness score 70/100 · Prevention and risk
• Dementia prevention, intervention, and care: 2020 report of the Lancet Commission The Lancet · 2020-07-30 · usefulness score 67/100 · Prevention and risk
• Mild cognitive impairment Lancet (London, England) · 2006-04-01 · usefulness score 64/100 · Prevention and risk
• Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1 Archives of neurology · 2003-10-01 · usefulness score 60/100 · How common it is
• Mild cognitive impairment: the Manchester consensus Age and ageing · 2021-01-01 · usefulness score 54/100 · Disparities
• Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis Alzheimer's research & therapy · 2023-07-22 · usefulness score 51/100 · Disparities

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• Impact of SSRI Therapy on Risk of Conversion From Mild Cognitive Impairment to Alzheimer's Dementia in Individuals With Previous Depression The American journal of psychiatry · 2017-11-28 · usefulness score 59/100
• Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild Cognitive Impairment Group Journal of Alzheimer's disease : JAD · 2018-01-01 · usefulness score 49/100
• Risk of dementia in MCI: combined effect of cerebrovascular disease, volumetric MRI, and 1H MRS Neurology · 2009-04-01 · usefulness score 49/100
• Patients with MCI and N400 or P600 abnormalities are at very high risk for conversion to dementia Neurology · 2007-12-12 · usefulness score 50/100

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