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Aspirin in people with dementia, long-term benefits, and harms: a systematic review
- Source :
- European Journal of Clinical Pharmacology. 77:943-954
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose People with dementia may have indications for aspirin prescription and clinicians are asked to balance the potential risks against benefits. This review examines the evidence for the risk and benefit of long-term aspirin use in people with dementia aged over 65 years, including randomised controlled trials and observational studies. Methods We searched three databases for research published between 2007 and 2020. Each eligible article was assessed for risk of bias, and confidence in findings was rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Four papers met inclusion criteria: one randomised controlled trial, two cohort studies, and one with pooled data. All looked only at dementia of Alzheimer’s type, and none addressed myocardial or cerebral infarction as outcomes. Dementia progression was reported by two studies, with conflicting results. The trial found no significant effect of aspirin on mortality (odds ratio aspirin vs. no aspirin 1.07, 95% confidence interval 0.58–1.97) but found more events of severe bleeding with aspirin (OR aspirin vs. no aspirin 6.9, 1.5–31.2). An excess in intracranial haemorrhage in the aspirin group was judged plausible based on two non-randomised studies. Conclusions The review findings are limited because studies include only people with Alzheimer’s-type dementia and lack confirmatory studies, although an increased risk of bleeding events is recognised. Further research that addresses the benefits and risks of aspirin in more representative groups of people with dementia is needed to guide prescribing decisions.
- Subjects :
- Pharmacology
medicine.medical_specialty
Aspirin
business.industry
General Medicine
Evidence-based medicine
Odds ratio
medicine.disease
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
medicine
Dementia
Pharmacology (medical)
Observational study
030212 general & internal medicine
Medical prescription
Intensive care medicine
business
030217 neurology & neurosurgery
Cohort study
medicine.drug
Subjects
Details
- ISSN :
- 14321041 and 00316970
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- European Journal of Clinical Pharmacology
- Accession number :
- edsair.doi...........af119029dcd7910385309f0539b6c0f6