ASPREE compared aspirin 100 mg daily with placebo in 19,114 independent older adults. Over a median 4.7 years, the main disability-free survival outcome did not significantly improve, while major bleeding was more frequent. ASPREE-XT follows the same parent trial; later medication use was not continuously randomized.
Boundary: Main combined outcome not significantly improved; no individual stopping conclusion.
JUPITER compared rosuvastatin 20 mg daily with placebo. This exploratory report concerns 5,695 participants aged 70 or older without cardiovascular disease, with LDL cholesterol below 130 mg/dL and elevated hsCRP (at least 2 mg/L). Fewer combined vascular events were reported; the mortality estimate remained uncertain.
Boundary: Exploratory subgroup with a selected inflammatory-risk profile; mortality remains uncertain.
PROSPER compared pravastatin 40 mg daily with placebo in 5,804 adults aged 70-82 with previous vascular disease or risk factors, followed for an average of 3.2 years. Fewer combined vascular events were reported; the mixed population limits application to healthy older adults.
Boundary: Mixed prevention population; the overall estimate is not a primary-prevention-only result.
Clarity AD: CLARITY AD showed less average cognitive-functional decline with lecanemab over 18 months, not recovery, with material ARIA and infusion-reaction risks.
Boundary: Both groups worsened; an 18-month randomized comparison does not demonstrate causal long-term extension benefit.
DO-HEALTH: DO-HEALTH's selected methylation substudy found small omega-3-related changes in PhenoAge, GrimAge2 and DunedinPACE, not proof of clinical rejuvenation or lifespan gain.
Boundary: Clock response does not establish lifespan extension or whole-body rejuvenation.
SELECT: SELECT demonstrated fewer major cardiovascular events with semaglutide in adults with established cardiovascular disease and overweight/obesity without diabetes, alongside greater treatment discontinuation.
Boundary: A secondary composite including macroalbuminuria is not proof of preventing kidney failure in all populations.