Aspirin's Cognitive Protection Is Genetically Determined by Platelet Levels

Scientists at Monash University, led by Peter Franske, have uncovered a genetic link that may determine aspirin's effectiveness in preventing cognitive decline. Their analysis of data from 13,500 participants in the ASPREE trial suggests that the protective benefits of aspirin against cognitive impairment are not universal but depend on an individual's genetic makeup.

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Trombophilia

Genetic Key to Aspirin's Cognitive Benefits

The research pinpointed specific genes that regulate platelet count as the crucial factor. It was found that individuals with the highest levels of these platelets, representing about 20% of the trial participants, experienced the most significant protective effect from aspirin. Over the observation period, dementia developed in just 1% of those taking aspirin, compared to 3.3% in the placebo group. This translated to a substantial relative risk reduction of nearly 70% for the aspirin group with high platelet counts.

Mechanism and Alzheimer's Distinction

Importantly, the genetic marker identified is not associated with genes known to cause Alzheimer's disease. The researchers hypothesize a biological mechanism where excessive platelet activity could lead to micro-clots and underlying inflammation within the brain's capillaries, contributing to cognitive impairment. Aspirin, by inhibiting platelet aggregation, may therefore mitigate these microvascular issues.

Persistent Risks of Aspirin Use

Despite the potential cognitive benefits, the study underscores that the risks associated with aspirin, particularly serious side effects, remain a significant concern. For the group with high platelet counts, the incidence of severe internal bleeding—affecting the stomach, intestines, or brain—more than doubled, rising from 2.1% to 4.4% among those taking aspirin daily.

Call for Personalized Medicine and Doctor Consultation

The authors of the study strongly emphasize that aspirin should only be considered as a tool for personalized preventive medicine after undergoing genetic testing and receiving a doctor's prescription. They warn that self-medicating with aspirin without understanding one's genetic profile poses a life-threatening risk due to the potential for severe bleeding events.

Source: This commentary was adapted from an original Russian-language publication by Pravda.Ru.