Randomized Clinical Trial of Daily Aspirin Therapy in Multi‐Infarct Dementia

Abstract

Seventy multi-infarct dementia patients were randomized into an aspirin-treated group and an untreated control group for an exploratory investigation to determine any effects of 325 mg aspirin daily on cognitive performance. The control group did not receive placebo but evaluations were carried out in a blinded manner. The index group (N = 37, mean age 67.1 years) received 325 mg of aspirin by mouth once daily while the control group (N = 33, mean age 67.6 years) was followed and treated in a similar manner except that they received no aspirin. Both groups had comparable risk factors for stroke, which were treated similarly, as well as comparable initial cerebral blood flow values, as measured by the 133xenon inhalation method, and initial scores on Cognitive Capacity Screening Examination testing. Patients were evaluated at intervals of one year. Significant improvements were demonstrated for cerebral perfusion values (P less than .0001) and cognitive performance scores (P less than .0001) among aspirin-treated patients compared to untreated controls at each of three annual follow-up evaluations. Both men and women benefited from aspirin therapy and their quality of life and independence appeared to be improved, which was not apparent in the control group. Daily aspirin appears to improve or stabilize declines in cerebral perfusion and cognition among patients with multi-infarct dementia.

Regular use of analgesics is a risk factor for renal cell carcinoma

“…There is epidemiological evidence that regular intake of aspirin or other forms of NSAID is protective against Alzheimer's disease and multi-infarct dementia, which constitutes the second commonest type of dementia among elderly people in the USA (Meyer et al, 1989). A large number of case-control and cohort studies have shown that use of NSAID is associated with a 30-50% reduction in risk of Alzheimer's disease (McGeer et al, 1996).…”

“…A large number of case-control and cohort studies have shown that use of NSAID is associated with a 30-50% reduction in risk of Alzheimer's disease (McGeer et al, 1996). In a randomized trial involving multi-infarct dementia patients, those taking one regular-strength (325 mg) aspirin daily for 3 years showed statistically significant improvement in both cerebral perfusion values and cognitive performance scores relative to the control group at each of the three annual follow-up evaluations (Meyer et al, 1989).…”

Is It Possible to Treat Vascular Dementia?

“…These include agents which affect cerebral blood flow. Meyer et al [19] report encouraging results from a randomized clinical trial testing 325 mg of aspirin per day in 70 patients with vascular dementia. Daily aspirin treatment improved cognitive performance and reduced or stabilized the decline in cerebral perfusion in this group of patients.…”

Pathogenetic mechanisms in vascular dementia

“…Diaschisis, appearing as bilateral reduction of the hemispheric blood flow, has been reported for patients with unilateral cerebral infarcts [41,42,61]. It has been suggested that all three mechanisms may play roles [24,43].…”

“…A pilot study [43] with aspirin (325 mg daily for 3 years) was promising and in two small series [4,47] elderly patients with cerebrovascular dementia treated with pentoxifylline had less deterioration of psychobehavioral scores than those treated with placebo. One study has proposed [79] the use of anticoagulant therapy in senile and presenile dementia, an approach that needs further confirmation.…”