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Results At baseline, mean vocabulary scores (an indicator of previous cognitive ability) were similar in the aspirin (30.9, SD 4.7) and placebo (31.1, SD 4.7) groups.

In the primary intention to treat analysis, there was no significant difference at follow-up between the groups in the proportion achieving over the median general factor cognitive score (32.7% and 34.8% respectively, odds ratio 0.91, 95% confidence interval 0.79 to 1.05, P=0.20) or in mean scores on the individual cognitive tests.

There were also no significant differences in change in cognitive ability over the five years in a subset of 504 who underwent detailed cognitive testing at baseline.

Conclusion Low dose aspirin does not affect cognitive function in middle aged to elderly people at increased cardiovascular risk. Cognitive function declines with age, and such decline is of increasing public health concern because of the burden it imposes on individuals, carers, and the wider society.1 2 Reduced levels of cognitive performance in older age have been associated with the presence of cardiovascular disease,3 4 possibly mediated through multiple small cerebral infarcts from microatheroma or thromboses in the brain.

Main outcome measures Tests of memory, executive function, non-verbal reasoning, mental flexibility, and information processing five years after randomisation, with scores used to create a summary cognitive score (general factor).

By Race/Ethnicity | By Sex | By Age | By Education | By Poverty Status Tobacco use remains the single largest preventable cause of death and disease in the United States.