Aspirin for vascular dementia (Cochrane Review)

A substantive amendment to this systematic review was last made on 20 August 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: Aspirin is widely prescribed for patients with a diagnosis of vascular dementia; in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered. Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition, does the risk of cerebral or gastric haemorrhage outweigh any benefit?

Objectives: To assess the evidence of effectiveness of the use of aspirin for vascular dementia.

Search strategy: Trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 22 January 2002 using the terms: aspirin and "vascu* or multi-infarct". This database contains records from all major medical databases and major trials databases and is updated regularly.In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references.

Selection criteria: All randomized controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias.

Data collection and analysis: Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim is to evaluate data recorded via tools assessing cognitive and behavioural changes along with mortality, morbidity and institutionalization data.

Main results: No trials are eligible for inclusion in this review.

Reviewers' conclusions: The most recent search for references to relevant research was carried out in January 2002, but no new trials were found. There is still no evidence that aspirin is effective in treating patients with a diagnosis of vascular dementia. Further research is needed to assess the effect of aspirin on cognition, and on other outcomes such as behaviour and quality of life. At present there is no evidence relating to other queries about the use of aspirin for dementia (these are described in the Background section of this review).

Citation: Williams PS, Rands G, Orrel M, Spector A. Aspirin for vascular dementia (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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File Reference: AB001296.htm