In fact, researchers found that people older than 70 and who take low doses of aspirin every day may be more likely to suffer from a serious fall—defined as a fall that required an emergency room visit and/or hospitalization.
“Falls and fractures are frequent and deleterious to the health of older people. Aspirin has been reported to reduce bone fragility and slow bone loss,” the authors wrote. However, the findings from this study “indicate a potential additional risk for the use of low-dose aspirin in older people.”
The researchers followed more than 16,000 people aged 70 or older, who were free of cardiovascular disease, dementia or physical disability. Half of the participants were assigned to take 100 milligrams of aspirin – a dose commonly recommended to older people – once a day while the rest of the participants took a placebo, said lead study author Anna Barker, PhD, of Monash University in Melbourne, Australia.
During the study period, 2,865 fractures occurred, and 1,688 participants suffered from a serious fall that required hospital care. Of those serious falls, 884 of them occurred in the group that took aspirin while 804 occurred in the placebo.
“The failure of low-dose aspirin to reduce the risk of fractures while increasing the risk of serious falls adds to evidence that this agent provides little favorable benefit in a healthy, white older adult population,” the authors wrote.
Connection between daily aspirin use and increased risk of serious falls in older adults
According to Barker, they “don’t exactly know.”
“The research didn’t give us the mechanism of why we found the outcome of increased serious falls in people that took aspirin,” she said. “But I guess it could be that there was anemia and people, therefore, experienced more falls as a result of anemia.”
She added people who suffer from a fall while taking aspirin may experience more severe injuries leading to increased bleeding, bruising or other muscle and joint injuries that could prompt emergency care.
Other health experts say more research is needed.
“Falls were higher in the aspirin group, but it was really falls that necessitated a hospital visit,” said Scott Kaiser, MD, geriatrician and director of geriatric cognitive health for the Pacific Neuroscience Institute in Santa Monica, California. “I couldn’t think of any clear mechanism by which taking aspirin would increase your risk of falling.”
Study limitations to consider
The authors noted that the results could not be applied or generalized to less healthy or higher-risk populations.
“If people are taking a secondary prevention – so they already had a stroke or heart attack – then this evidence really doesn’t apply to them,” Barker said. “It is focused on those who haven’t had a stroke or heart attack previously.”
In addition, the treatment duration and dosage of aspirin used in the study may not have been sufficient enough to allow for a “full effect.”
Further, Cristina Marti-Amarista, MD, a geriatric fellow at New York-based Stony Brook Medicine, said errors in the design of the study and lack of follow-up could increase the risk of bias and limit the application of the results to the general population.
“With a follow-up of five years, it is possible that cognitive impairment or dementia developed and the subjects had a decline in functional capacity,” she said.
What the study means for older adults who use aspirin
Despite what the study found, you should not stop or start taking daily aspirin without discussing it with your health care provider first, Marti-Amarista said.
“The results of this study should not be taken as a recommendation for patients and families to stop aspirin treatment.”
“Most importantly, every medication has risks, as well as benefits,” Barker added. “Sometimes we focus on all of the benefits of medications without considering the risks, and so they need to be weighed with every medication you take.”
If you’re concerned about fractures and falls, Kaiser recommends incorporating preventive health strategies and lifestyle behaviors into your daily routine.
Kaiser added that guidelines for aspirin use and dosage will depend on each individual and their personal health risk factors.
“They should really talk to their doctor in terms of weighing the potential risks and benefits because it’s different if you’re healthy versus if you have certain risk factors,” Kaiser added. “The guidance would also be different depending on your age and your particular situation.”
Current guidelines for aspirin use
- Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) among adults 40 to 70 years who are at higher risk of ASCVD but are not at an increased bleeding risk.
- Low-dose aspirin (75-100 mg orally daily) should not be used on a routine basis for the primary prevention of ASCVD among adults 70 years or older.
- Low-dose aspirin (75-100 mg orally daily) should not be used for the primary prevention of ASCVD among adults of any age who are at an increased risk of bleeding.