Background Frailty is associated with chronic inflammation, which may be modified by aspirin. The purpose of this study was to determine whether low-dose aspirin reduces incident frailty in healthy older adult participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Methods In the United States and Australia, 19 114 community-dwelling individuals aged ≥70 and older (U.S. minorities ≥65 years) and free of overt cardiovascular disease, persistent physical disability, and dementia were enrolled in ASPREE, a double-blind, placebo-controlled trial of 100-mg daily aspirin versus placebo. Frailty, a prespecified study end point, was defined according to a modified Fried frailty definition (Fried frailty) and the frailty index based on the deficit accumulation model (frailty index). Competing risk Cox proportional hazard models were used to compare time to incident frailty by aspirin versus placebo. Sensitivity analysis was conducted to include frailty data with and without imputation of missing data. Results Over a median 4.7 years, 2 252 participants developed incident Fried frailty, and 4 451 had incident frailty according to the frailty index. Compared with placebo, aspirin treatment did not alter the risk of incident frailty (Fried frailty hazard ratio [HR]: 1.04, 95% confidence interval [CI] 0.96−1.13; frailty index HR: 1.03, 95% CI 0.97−1.09). The proportion of individuals classified as frail, and the trajectory in continuous frailty scores over time, were not different between the aspirin and placebo treatment groups. The results were consistent across a series of subgroups. Conclusions Low-dose aspirin use in healthy older adults when initiated in older ages does not reduce risk of incident frailty or the trajectory of frailty.

中文翻译：

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在阿司匹林减少老年人事件研究中，低剂量阿司匹林对社区居住老年人的虚弱表型和虚弱指数的影响

背景虚弱与慢性炎症有关，而阿司匹林可以缓解这种炎症。本研究的目的是确定低剂量阿司匹林是否可以减少阿司匹林减少老年人事件 (ASPREE) 试验的健康老年参与者的虚弱事件。方法 在美国和澳大利亚，19114 名年龄≥70 岁及以上（美国少数民族≥65 岁）且无明显心血管疾病、持续性身体残疾和痴呆症的社区居民被纳入 ASPREE，这是一种双盲、安慰剂-每天服用 100 毫克阿司匹林与安慰剂的对照试验。虚弱是一个预先指定的研究终点，是根据修改后的 Fried 虚弱定义（Fried frailty）和基于赤字累积模型的虚弱指数（虚弱指数）定义的。竞争风险 Cox 比例风险模型用于比较阿司匹林与安慰剂引起虚弱事件的时间。进行了敏感性分析，以包括有和没有缺失数据插补的虚弱数据。结果 在平均 4.7 年的时间里，2 252 名参与者出现 Fried 衰弱事件，根据衰弱指数，4 451 名参与者出现事件衰弱。与安慰剂相比，阿司匹林治疗并未改变虚弱事件的风险（Fried 虚弱风险比 [HR]：1.04，95% 置信区间 [CI] 0.96-1.13；虚弱指数 HR：1.03，95% CI 0.97-1.09）。阿司匹林和安慰剂治疗组之间被归类为虚弱的个体比例以及连续虚弱评分随时间变化的轨迹没有差异。结果在一系列子组中是一致的。