Genetic Profile May Cut Dementia Risk by 70% with Aspirin

Researchers at Monash University have identified a potential link between low-dose aspirin and a substantially reduced risk of dementia in a specific subset of older adults. The analysis suggests that genetic factors may determine who benefits from this preventive treatment, although the findings come with significant caveats regarding safety.

Genetic Markers and Platelet Counts

The study focused on participants possessing a particular genetic profile associated with platelet count. Data was drawn from more than 13,500 individuals involved in the ASPREE Trial (Aspirin in Reducing Events in the Elderly). By comparing genetic scores against clinical outcomes, investigators sought to understand if inherited differences could explain varying responses to aspirin.

Among those in the highest 20 percent for this genetic score, the results showed a stark contrast in dementia incidence. Only 1 percent of aspirin recipients developed dementia, compared to 3.3 percent of those taking a placebo. This translates to an approximate 70 percent relative reduction in risk. In absolute terms, the difference amounted to 2.3 percentage points, or roughly 23 fewer dementia cases per 1,000 people.

Bleeding Risks Remain Concerning

Despite the promising reduction in dementia cases, the same group experienced higher rates of serious bleeding. Major bleeding events occurred in 4.4 percent of aspirin users versus 2.1 percent of placebo users within this genetically defined cohort. This equates to approximately 23 additional major bleeding incidents per 1,000 individuals.

Dr. Peter Fransquet, lead author and research fellow at Monash’s School of Public Health and Preventive Medicine, noted that previous trials failed to show broad preventive effects when analyzing all participants together. “Our findings suggest there may be more to the story,” Dr. Fransquet stated. He emphasized that genetics might eventually help identify candidates for preventive treatment, moving away from a one-size-fits-all approach.

Implications for Personalized Prevention

The research highlights the role of platelet biology rather than established genetic risk factors for Alzheimer’s disease. While scientists have previously connected platelet activation and aggregation to dementia, the impact of overall platelet count has remained less clear. Dr. Fransquet described this as a new avenue for investigation.

Dementia Australia estimates that 446,500 Australians are currently living with the condition in 2026, projecting that number to exceed one million by 2065. However, the current analysis does not establish a treatment strategy but rather identifies a population worth further study. A dedicated trial targeting this specific genetic profile is necessary to confirm whether the apparent benefit is reproducible and how it balances against the increased bleeding risk.

Medical professionals advise against self-prescribing aspirin based on these findings without consulting a doctor, particularly due to the heightened risk of serious bleeding. If future studies validate the results, the widespread availability and low cost of aspirin could make personalized dementia prevention a realistic possibility.