Finding a midlife risk factor for dementia—such as migraine—could allow for earlier detection of at‐risk patients.
A history of migraines was a significant risk factor for Alzheimer disease (AD) and all‐cause dementia, but not vascular dementia, in a recent study examining older adults living independently.
The researchers used a subset of data from the Manitoba Study of Health and Aging, part of the longest continuous study of aging in Canada. Analyses were based on 679 community‐dwelling participants 65 years or older.
Dementia is the most common neurological disease in older adults, and identifying predictors of dementia is critical, researchers noted, given the current increases in prevalence and expected further growth as the population ages.
Headaches, including migraines, are the most common neurological disorder across all ages; previous studies have found some suggestions of an association between migraine and dementia. However, the associations are poorly defined and may vary by dementia subtype, headache/migraine measure, gender, comorbidities, and clinical versus community‐based samples.
Finding a midlife risk factor for dementia—such as migraine—could allow for earlier detection of at‐risk patients. A better understanding of a possible relationship could include earlier screening for cognitive decline in patients with migraine, as well as interventions to delay dementia, to improve the quality of life, and to increase the likelihood of healthy aging.
To be included in the study, participants were screened to determine that their cognition was unimpaired at baseline. Researchers collected data on migraine history and all covariates at baseline; 5 years later, they were re-assessed for cognitive outcomes (all‐cause dementia, AD, and vascular dementia).
The association of a lifetime history of migraines, confounding varianvles (age, gender, education, and depression), and intervening variables (hypertension, myocardial infarction, other heart conditions, stroke, and diabetes) with all‐cause dementia and dementia subtypes (AD and vascular dementia) was assessed using multiple logistic regression models.
The sample was predominantly women (61.9%) with a mean age of 75.9 years.
Patients with a history of migraines were 3 and 4 times more likely to be diagnosed later with both all‐cause dementia (odds ratio [OR], 2.97; 95% CI, 1.25‐6.61) and AD (OR, 4.22; 95% CI, 1.59‐10.42), even after adjustment for confounding and intervening variables.
However, migraines were not significantly associated with vascular dementia either before (OR, 1.83; 95% CI, 0.39‐8.52) or after (OR, 1.52; 95% CI, 0.20‐7.23) such adjustment, despite vascular involvement in migraines.
At follow‐up 5 years later, 7.5% (n = 51) of participants had developed dementia, 5.1% (n = 34) had developed AD, and 1.9% (n = 12) had developed vascular dementia. However, no men reporting a history of migraines were diagnosed with dementia.
Those with dementia, AD, or vascular dementia were significantly older; those with dementia or AD had significantly less education. Stroke was significantly more common in participants with dementia or vascular dementia than in those whose cognition was unaffected.
Although stroke was not an independent statistically significant predictor of dementia, it met statistical criteria to be included in the fully adjusted model.
Morton RE, St. John PD, Tyas SL. Migraine and the risk of all‐cause dementia, Alzheimer’s disease, and vascular dementia: a prospective cohort study in community‐dwelling older adults [published online September 4, 2019]. Int J Geriatr Psychiatry. doi: 10.1002/gps.5180.