Migraine Headaches Significantly Associated with Dementia in Women

by | Oct 8, 2020 | 2019, Alzheimer's Disease, Brain Health, Headaches

Written by Joyce Smith, BS. In a United Kingdom study, migraine diagnoses were positively associated with all-cause dementia and Alzheimer’s disease in the elderly population, but differed substantially between men and women.

MigraineIn 2016 migraine headaches affected approximately one billion people annually 1, translating into many days lived with disability and imposing a continually increasing economic burden of lost productivity 2 and increased health care costs 3. Previous studies on migraine headaches have been done, including a recent 2019 study of 57,000 participants, that found a positive but non-significant association between migraine headaches and dementia 4; however, there was no accounting for significant bias- contributing comorbidities such as depression 5, stroke 6 and diabetes 7 and the studies could not be extrapolated to people living in the United Kingdom. Thus, with an anticipated rise of a dementia-burdened population to one million by the year 2013 8, the research team of Kostev and colleagues did a retrospective  study 9 to determine whether a migraine diagnosis correlates with dementia in a cohort of 7,454 patients followed in United Kingdom (UK) general practices.

The team used data obtained from the Disease Analyzer database (IQVIA), which compiles drug prescriptions, diagnoses, and basic medical and demographic data. They obtained the data obtained directly and in an anonymous format from computer systems used by general practitioners and specialists in the United Kingdom. Of the 7,454 study participants followed by the Kostev team, 3,727 were diagnosed with migraine and the remaining 3,727, who were migraine free, were used as controls. All had been seen in one of 67 general practices in the UK between January 1997 and December 2016 (index date). Mean participant age was 67 years with 72.9% of women. Primary outcome was the incidence of AD and vascular or non-specific dementia as a function of migraine diagnosis within 10 years of the index date.

Of the 7,454 participants with or without dementia, 62 % had hyperlipidemia, 29.4% suffered from depression, and 14.7% were diabetic. Within 10 years of the index date, a significantly higher number of participating women with a migraine diagnosis developed dementia (5.8%) compared to 3.7% of the migraine-free women (P<0.001), whereas a non-significant 4.5% of men with a migraine diagnosis developed dementia compared to 3.4% of men with no migraine diagnosis (P=0.722). The significant positive association in women included all-cause dementia and Alzheimer’s disease.

While this study found a positive association between dementia and AD in only women, the results align with a previous study 4 where migraine diagnosis in men did not increase their dementia risk compared to controls.  Dementia exhibits major sex differences which may explain the increased dementia risk for women with migraine 10. Men were also found to be older before migraine onset, had less severe migraine attacks that were of shorter duration 11, and were also prescribed less anti- depression and anti- anxiety medications. In addition, chronic pain was shown to exacerbate dementia risk in women 12. Since the relationship between migraine and dementia may differ substantially between men and women, it would be prudent to screen elderly populations with migraine history for dementia risk. Future studies are warranted to gain a better understanding of the underlying mechanisms that account for the sex differences on migraines. As well, the impact of sex differences on migraines suggests that future preventive interventions for dementia should be tailored to men and women separately 10.

Study limitations include a potential statistical analysis bias due to the inclusion of only elderly 60-80 year olds, yet migraines are most common among young adults and usually decrease with age. Also in the elderly, headaches relating to ischemic cerebral lesions may be potentially misdiagnosed as migraines. Finally, it would have lent more credence to the study had information been made available as to how general practitioners’ diagnoses of migraine compared with the standard diagnostic procedures used in neuropsychiatric practices.

Source: Kostev, Karel, Jens Bohlken, and Louis Jacob. “Association between Migraine Headaches and Dementia in more than 7,400 Patients Followed in General Practices in the United Kingdom.” Journal of Alzheimer’s Disease 71, no. 1 (2019): 353-360.

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Posted October 8, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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