Low-Dose Aspirin & Age-Related Hearing Loss: No Effect

Researchers investigated the impact of daily low-dose aspirin against placebo on the progression of age-related hearing loss in healthy older persons in a recent study that was published in the JAMA Network Open.

Background
More than half of persons 70 years of age or older suffer from age-related hearing loss, which can lower their quality of life and cause melancholy and social isolation. High-frequency loss and reduced speech discrimination are its defining characteristics.

Two known risk factors are diabetes and smoking. The pathogenesis includes hair cell loss and stria vascularis atrophy, which is the withering of cochlear tissue. Cochlear degeneration is also known as inner ear degradation.

Microvascular alterations could be a factor in this deterioration. Aspirin may improve cochlear blood flow and lessen cellular damage because it is well-known for lowering inflammation and inhibiting platelet aggregation. Human data, however, are not reliable.

The possible long-term advantages and efficacy of substitute anti-inflammatory medications in delaying the advancement of age-related hearing loss require more investigation.

About the study
19,114 people were enrolled in the current double-blind, randomized, placebo-controlled study between January 2010 and December 2014.

Every year and every six months, participants who were free of serious cognitive decline, heart disease, dementia, major disability, or life-limiting illness were called in for follow-up.

Participants were randomized to receive either a placebo or 100 mg daily of enteric-coated aspirin following a 4-week placebo run-in to evaluate adherence.

Portable audiometers were used in community centers, clinics, or mobile vans to check people’s hearing (apart from those with deeply implanted hearing aids or bilateral cochlear implants). At baseline, 18 months, and 3 years, measurements were made of speech perception in noisy environments and air conduction thresholds.

The primary results of the study were measures of hearing, such as speech reception threshold (SRT), 4 frequency average (4FA), and mean sound detection thresholds for individual pure tones.

The year three assessment was completed by only 22% of participants and was abruptly discontinued in June 2017. A statistical analysis conducted from June to December 2023 using a linear mixed model revealed no significant differences in hearing outcomes between the aspirin and placebo groups.

In conclusion
In summary, this study showed that among healthy volunteers aged 70 years or older, a daily intervention of 100 mg aspirin over a three-year period had no discernable effect on the course of hearing loss.

When the results were broken down by age, sex, smoking status, and diabetes, the results did not change. SRT and perceived functional hearing limits (HHIE-S) were unaffected by low-dose aspirin.

The trial did not reveal any negative consequences connected to aspirin use, nor did it demonstrate any beneficial influence on hearing acuity or functional hearing abilities, despite data suggesting aspirin may be able to treat the microvascular and inflammatory components of age-related hearing loss.

For more information: Low-Dose Aspirin and Progression of Age-Related Hearing Loss: A Secondary Analysis of the ASPREE Randomized Clinical Trial, JAMA Netw Open, doi:10.1001/jamanetworkopen.2024.24373