NIH Record - National Institutes of Health

Low-Dose Aspirin May Increase Risk of Anemia in Older Adults

Several white pills held in cupped hand
A warning for older adults who take low-dose aspirin

Photo:  Elen Nika/Shuttershock

A recent follow-up analysis of data from an international, NIH-funded clinical trial suggests daily low-dose aspirin increases the risk of anemia in people ages 65 years and older by approximately 20%. Given these findings, older adults on low-dose aspirin and their care providers may want to consider periodic monitoring of red blood cells or hemoglobin. Anemia in older adults is associated with functional decline, increased fatigue, disabilities, depressive symptoms and cognition problems.

Published in the Annals of Internal Medicine, scientists from the Aspirin in Reducing Events in the Elderly (ASPREE) study examined the effect of long-term low-dose aspirin use on incident anemia and the effect of aspirin on changes in hemoglobin concentration, as well as ferritin levels, as an indicator of iron deficiency. The researchers found that low-dose aspirin led to increased incident anemia in otherwise healthy older adults at enrollment, independent of major bleeding.

Previous ASPREE data analyses suggested daily low-dose aspirin does not decrease risk for dementia and cognitive decline; and that daily low-dose aspirin had no effect on healthy lifespan in older people.

ASPREE, a joint U.S. and Australian research project aimed at determining the effect of low-dose aspirin on survival without dementia or disability, began in 2010 and completed recruitment in 2014. It was a randomized, double-blind, placebo-controlled, primary prevention trial of daily 100 mg of aspirin in a population of healthy older people in the U.S. and Australia with a period of treatment averaging 4.5 years. The trial involving 19,114 people ages 65 and older was distinctive for its size, methodological rigor, and high participant retention rate in both countries.

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