Approved Research

Low-dose acetylsalicylic acid use, its neuroprotective and gastrointestinal implications

Lay summary

Acetylsalicylic acid, commonly known as aspirin, is often used in low doses for the prevention of myocardial infarctions and strokes in patients . Although the risks and benefits of aspirin is well known, its potential for neuroprotection is still unclear. Large observational studies supported, at least partially, the possibility that aspirin could protect against dementia, particularly with prolonged therapy. However, the majority of studies have yieled conflicting results so far.

Low-dose aspirin, when used chronically, and Helicobacter (H) pylori are risk factors for peptic ulcer disease. Through their gastrotoxic mechanisms, low-dose aspirin might interact with H pylori creating an unpredictable net result at the gastroduodenal system. However, to which extent infection H pylori alters the risk of low-dose ASA use is unclear. Literature addressing this association is mostly indirect and limited by small sample-size studies with no serologic examination.  

The UK Biobank study, with its long follow-up time and serologic examination, is the ideal data source to address the following research aims: 1) To assess the associations of low-dose aspirin use with the incidence of all-cause dementia, Alzheimer's disease and vascular dementia. 2) To assess the associations of low-dose aspirin use with the development of gastric and duodenal ulcers taking into account a potential interaction with H pylori infection.

All research questions shall be answered within 24 months. If low-dose aspirin use is associated with reduced dementia incidence, it might be further recommended as primary prevention for such diseases. The results will also answer the question of whether there is a need for H pylori testing and eradication before low-dose aspirin therapy could be started.