Inflammation, Frailty, and Aspirin Use in the Physicians' Health Study: A Pilot Study.

Whether anti-inflammatory medications such as aspirin can lower the risk of frailty is an active area of investigation. In previous studies, we reported that regular aspirin use started in midlife was associated with a lower risk of frailty at older age. We therefore sought to further examine the relationship between inflammatory biomarkers, frailty and aspirin use in a pilot nested case-control study of 300 participants aged ≥60 years with available data to calculate a frailty index from the Physicians' Health Study, a completed randomized trial of aspirin that began in 1982. We selected 150 individuals who were frail (frailty index >0.2) and 150 who were not frail (frailty index <0.1). We then matched 29 low users of aspirin (≤60 days/year) 3:1 to 87 regular users of aspirin (>60 days/year). After matching on age, smoking status, history of diabetes and CVD, there was no significant association between aspirin use and level of frailty among those with elevated inflammatory biomarkers (all p>0.05). In this pilot study we did not find evidence of a mediation effect of CRP, TNFR-2 or IL-6 on the association between aspirin and frailty. Additional work is needed to elucidate the potential mechanistic pathways through which medications such as aspirin may be linked with frailty.