Taking aspirin daily for years does not help healthy older adults live longer, even though it affects heart attacks and bleeding, because the risks and benefits cancel each other out.
Evidence from Studies
No evidence studies found yet.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
A meta-analysis of all RCTs of aspirin for primary prevention in older adults would definitively determine whether any net effect on all-cause mortality exists.
A systematic review and meta-analysis pooling individual-level all-cause mortality data from all completed RCTs of daily low-dose aspirin versus placebo in adults aged 70+, with minimum 5-year follow-up, adjusting for age, sex, diabetes, and baseline CVD risk, and stratifying by duration of use.
A new RCT could confirm whether aspirin affects mortality in a specific high-risk subgroup of older adults with elevated inflammation.
A double-blind RCT of 10,000 adults aged 70+ with elevated hs-CRP (>2 mg/L) and no CVD, randomized to 100 mg aspirin or placebo daily for 7 years, with primary outcome being all-cause mortality, secondary outcomes including cardiovascular death, cancer death, and hemorrhage-related death.
A cohort study could assess whether aspirin use is associated with lower mortality in real-world older adults with varying comorbidities.
A prospective cohort of 20,000 adults aged 70+ with annual aspirin use assessment, linked to national death registries over 10 years, adjusting for statin use, smoking, BMI, and chronic kidney disease, to estimate hazard ratios for all-cause mortality.
A case-control study could identify whether aspirin users who die have different prior medication patterns than non-users who die.
A nested case-control study within a primary care database comparing 2,000 older adults who died from any cause to 6,000 matched survivors, assessing aspirin use (duration, dose, timing) and concomitant medications in the 5 years prior to death.
A cross-sectional survey could estimate the proportion of older adults taking aspirin who report being alive, but cannot determine causality.
A national survey of 10,000 adults aged 70+ asking about current aspirin use and survival status, with self-reported survival confirmed via family or registry data, to estimate prevalence of survival among users versus non-users at a single time point.