TL;DR
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A Monash University analysis of more than 13,500 ASPREE trial participants found that, among people in the highest fifth of a platelet-count genetic score, dementia occurred in 1% of aspirin users and 3.3% of placebo users. Major bleeding was also more frequent in the aspirin group, and researchers say the finding needs replication and a targeted clinical trial before it can inform treatment.
A Monash University analysis found that older adults in the highest fifth of a genetic score associated with platelet count had a lower observed dementia rate if assigned low-dose aspirin rather than placebo, but also a higher rate of major bleeding. The results, based on genetic data from more than 13,500 ASPREE trial participants, suggest a possible difference in aspirin’s effects by genetic profile; they do not establish that people should take aspirin to prevent dementia.
In the genetic group with the highest platelet-count scores, dementia developed in 1% of aspirin users, compared with 3.3% of placebo users. The researchers described this as about a 70% lower relative risk in that subgroup. These are observed trial-group rates, not proof that aspirin will prevent dementia in people with the same genetic profile.
The safety finding went in the opposite direction: major bleeding occurred in 4.4% of aspirin users in that genetic group, compared with 2.1% of those given placebo. The analysis therefore points to a possible benefit accompanied by a serious potential harm. It does not establish an individual’s likely balance of benefit and risk.
The study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, examined whether genetic differences might help explain why earlier aspirin trials found no dementia-prevention effect when participants were considered as a whole. The analysis focused on genetic scores linked to platelet count. It did not test a screening program or make a clinical recommendation.
A Possible Benefit With a Bleeding Trade-Off
The results may help researchers investigate whether prevention strategies work differently across groups, rather than assuming a single effect for everyone. A genetic marker that identifies a subgroup with a different response could eventually inform research into more targeted prevention. For now, though, this is a signal from an analysis of existing trial data, not a validated way to select patients for aspirin.
The difference in major bleeding rates is central to interpreting the finding. Aspirin can increase bleeding risk, and the study’s subgroup results do not show that the apparent dementia difference outweighs that harm for any particular person. Decisions about aspirin should be made with a qualified health professional, based on a person’s circumstances and established medical indications—not this analysis alone.
The study also directs attention toward platelet biology, a possible avenue for dementia research distinct from established genetic risk factors for Alzheimer’s disease and other dementias. That may help shape future studies, but it does not yet change prevention guidance.
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What ASPREE Adds to the Finding
The analysis drew on the ASPREE trial, a large study of aspirin use among older adults. Researchers used participants’ genetic data to examine whether inherited differences associated with platelet count could be related to dementia outcomes in the aspirin and placebo groups. Because the underlying trial included a placebo comparison, the analysis could compare outcomes by treatment assignment as well as genetic-score group.
Prior research has linked dementia with platelet activation and aggregation, processes involved in blood clotting. The Monash team examined whether genetic variation related to overall platelet count might also matter. The reported signal was not linked to established dementia risk genes, according to lead author Dr. Peter Fransquet, but the findings do not show that platelet count itself causes dementia or that aspirin’s effect operates through a confirmed biological pathway.
Earlier trials had not found that aspirin prevented dementia when results were assessed across all participants, Fransquet said. The new analysis asks whether an average result might obscure differences between genetic subgroups. Dementia’s growing impact adds urgency to such research: Dementia Australia estimates that about 446,500 people in Australia are living with dementia in 2026 and projects the number will exceed one million by 2065.
“In people with this particular genetic profile, we saw substantially fewer cases of dementia among those taking aspirin.”
— Dr. Peter Fransquet
The Genetic Signal Still Needs Testing
It is not yet clear whether the association will appear in other populations or in independent studies. The analysis identifies a difference within one genetic-score subgroup, but does not establish that the score can reliably predict who benefits from aspirin, nor does it explain the biological mechanism behind the result.
The reported percentages also do not settle how aspirin’s possible dementia effect compares with its bleeding risk for individuals. Researchers have not yet tested a treatment strategy designed specifically for people with this genetic profile. The source report does not provide enough detail here to determine how the finding would apply across different demographic groups or to people with other health conditions and medication use.
Replication Before Any Treatment Trial
Researchers say the next step is to check whether the association can be reproduced in other studies and populations. If it holds up, they say a clinical trial designed specifically for people with the identified genetic profile would be needed to test whether aspirin changes dementia risk in that group and to evaluate harms.
Until those steps are completed, the finding remains a research result rather than a basis for preventive prescribing. Readers should not start aspirin to prevent dementia on the strength of this analysis; anyone considering aspirin should discuss it with a qualified health professional.
Key Questions
What did the analysis find?
Among participants in the highest fifth of a platelet-count genetic score, dementia occurred in 1% of aspirin users and 3.3% of placebo users. Researchers described the difference as about a 70% lower relative risk in that subgroup, but say it needs confirmation.
What is the safety concern?
In the same genetic group, major bleeding was reported in 4.4% of aspirin users and 2.1% of placebo users. The finding highlights a potential harm alongside the lower observed dementia rate.
Should people take aspirin to prevent dementia?
No treatment recommendation follows from this analysis. Its lead author advised against starting aspirin for dementia prevention based on the study and urged people to consult a doctor, particularly because of serious bleeding risk.
Does the study prove that platelet genes cause dementia?
No. The analysis found an association involving a genetic score related to platelet count. It does not prove that platelet count causes dementia or confirm the mechanism behind the observed difference.
What research is needed next?
The researchers say the finding should first be checked in other studies and populations. If replicated, a clinical trial specifically enrolling people with the identified genetic profile would be needed to test the result.
Source: rss
