The widespread practice of daily low-dose aspirin for cardiovascular protection may not extend meaningful brain benefits to healthy older adults, challenging assumptions about its neuroprotective potential during aging. This finding carries particular weight given aspirin's anti-inflammatory properties and theoretical capacity to preserve cerebral blood flow.
The ENVIS-ion substudy within the larger ASPREE trial tracked brain health markers in participants taking 100mg daily aspirin versus placebo over three years. Researchers measured white matter hyperintensities through MRI scanning and assessed retinal vessel caliber as indicators of cerebrovascular health. White matter lesions represent areas of reduced blood flow that accumulate with age and correlate with cognitive decline risk. The study found no statistically significant differences between aspirin and placebo groups in either marker progression, suggesting the anti-platelet medication does not meaningfully slow these age-related vascular changes in the brain.
This neuroimaging evidence adds important context to aspirin's complex risk-benefit profile in aging populations. While previous studies suggested anti-inflammatory medications might protect against neurodegeneration, this controlled trial data indicates such benefits may be minimal or require longer observation periods. The findings align with growing recognition that aspirin's cardiovascular benefits in primary prevention must be weighed against bleeding risks, particularly in older adults. However, the three-year timeframe may be insufficient to capture subtle neuroprotective effects, and the study focused on healthy participants rather than those with existing cardiovascular risk factors. This represents incremental but valuable evidence refining our understanding of aspirin's role beyond traditional cardiovascular endpoints in healthy aging.