The study examined the relationship between aspirin use and decline in intrinsic capacity (IC) among older adults living in Chinese communities. The research included 250 participants and used statistical methods to reduce the influence of various confounding factors. It was found that aspirin use alone did not significantly reduce the risk of severe decline in intrinsic capacity. However, aspirin use was strongly associated with negative outcomes in sensory function, including very poor vision (increased risk 2.95-fold), poor hearing (3.21-fold), and very poor hearing (2.08-fold). When aspirin was combined with ACE inhibitors or angiotensin receptor blockers, the incidence of severe decline in intrinsic capacity was significantly reduced. The occurrence of negative effects differed between men and women.