Key result
Daily aspirin fails to prevent physical decline or incident weakness in older adults.
Why the study?
Grip strength and gait speed are key markers of physical functional capacity and general health in older people, but the effect of low-dose aspirin on these measures remained to be examined.
Does 100 mg daily aspirin prevent declines in grip strength and gait speed in community-dwelling older adults?
RCT (n=19,114)
Double-blind
Block randomization
Yes
Does 100 mg daily aspirin prevent declines in grip strength and gait speed in community-dwelling older adults?
Hazard Ratio: 1.05 (95% CI 1–1.1)
Absolute Event Rate: 98.4% vs 93.9%
Low-dose aspirin does not preserve physical function in healthy older adults; reinforces evidence against routine primary prevention.
BACKGROUND: Grip strength and gait speed are key markers of physical functional capacity and general health in older people. This study aimed to examine the effect of low-dose aspirin on handgrip strength and habitual gait speed in relatively healthy older people. METHODS: The ASPREE (ASPirin in Reducing Events in the Elderly) trial randomized 19 114 community-dwelling Australians and US adults aged 70+ years (US minorities ≥65 years) who were free of overt cardiovascular disease, dementia, and limitations in activities of daily living to daily 100 mg aspirin versus placebo. Linear mixed models were used to compare the effects of treatment groups on changes in grip strength and gait speed over time, and Cox proportional hazard models were used to compare time to incident grip weakness and gait slowness between aspirin and placebo groups. RESULTS: Over a median of 4.7 years, the changes in grip strength (β: 0.001; 95% CI: -0.004 to 0.005) and gait speed (β: -0.004; 95% CI: -0.010 to 0.001) did not differ significantly between aspirin and placebo groups. Over the study period, 6203 participants experienced incident grip weakness, and 6947 had incident gait slowness. There was no difference in the risk of incident grip weakness (Hazard Ratio (HR): 1.05; 95% CI: 1.00, 1.10) and gait slowness (HR: 1.00; 95% CI: 0.95, 1.05) between individuals randomized to aspirin versus placebo. CONCLUSIONS: Low-dose aspirin use in relatively healthy older people did not affect gait speed or grip strength over time or reduce the risk of weakness and slowness.
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Phyo et al. (2025) conducted an RCT in Healthy community-dwelling older adults (n=19,114). Aspirin vs. Placebo was evaluated on Incident grip weakness (HR 1.05, 95% CI 1.00-1.10). Low-dose daily aspirin use in relatively healthy older people did not significantly affect gait speed or grip strength trajectories over time, nor did it reduce the risk of incident grip weakness (HR 1.05) or gait slowness (HR 1.00).
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