Written by Angeline A. De Leon, Staff Writer. This study suggests that a history of migraines increases the risk of dementia in women, particularly in women who are sixty years of age or older.
Migraine affects millions of individuals worldwide, the prevalence rate ranging from 5% to 15% 1. Marked by recurrent episodes of throbbing pain or pulsating sensations on the side of the head 2, migraines are considered a neurological condition involving an excitatory-inhibitory imbalance in the brain 3. Research has shown that individuals suffering from migraines also exhibit distinct functional and structural changes at the cortical level, which may be related to increased risk of cognitive dysfunction 4,5. A large population-based study demonstrated, for example, that subjects experiencing migraines were at higher risk for any type of dementia 6, while a recent meta-analytic study reported a general relationship between migraine attacks (duration, severity, and frequency) and neuropsychological impairment 7. Although the exact neurophysiological mechanisms associated with migraines are still under study, brain imaging studies suggest that decreased cerebral blood flow and inflammatory pathways may be involved 8,9. Long-lasting migraines may even cause permanent brain damage due to sustained elevations in oxidative stress, leading to neurodegeneration 10,11. Overall, neuroimaging research suggests that neural changes associated with cognitive impairment during migraine attacks may also overlap with those observed in cases of dementia 12. To validate this, a recent case-control study 13 published in Medicine (2019) sought to determine the relationship between prior history of migraine and diagnosis of dementia.
A total of 11,438 dementia patients (diagnosed with Alzheimer’s Disease or dementia in Alzheimer’s Disease and receiving 2 or more medical treatments for their condition) and 45,752 control participants (all aged 60 years and older) were enrolled in a national, nested case-control study and matched 1:4 based on age, sex, income, region of residence, and past medical history (hypertension, diabetes, and dyslipidemia). Migraine was diagnosed using the ICD-10 (International Classification of Diseases, 10th Revision) and only included patients who visited an outpatient clinic twice or more for the same migraine episode. Odds Ratios (ORs) were calculated for migraine with dementia.
Compared to the control group, the rate of a reported history of migraine was found to be significantly higher in the dementia group (7.7% [881/11,438] vs. 6.3% [2,888/45,752]) (p < 0.001). Adjusted OR for migraine with dementia was also 1.13 times higher in the dementia group vs. control (95% Confidence Interval: 1.05 to 1.23) (p = 0.02). Finally, a subgroup analysis based on age and sex revealed a significantly higher adjusted OR for migraine with dementia in women vs. men (OR for women younger than 70 = 1.35 [95% CI: 1.08 to 1.68], OR for women 70 years and older = 1.12 [95% CI= 1.02 to 1.23]) (p < 0.05 for both).
Based on findings, researchers conclude that having a history of migraine seems to increase the risk of developing dementia, with the strongest association between migraine and dementia observed for women younger than 70 years old. This finding appears to be congruent with evidence indicating a higher risk of dementia in women vs. men 14 and a stronger association between dementia and migraine in younger rather than older individuals 6. Prospective studies are needed to further explore these sex- and age-based differences. Several study limitations should be considered in the current investigation, including the inability to draw causal relations due to the nature of the study design; failure to include different subtypes of dementia; and lack of control for confounding variables such as depression and anxiety.
Source: Lee S-Y, Lim J-S, Oh DJ, et al. Increased risk of neurodegenerative dementia in women with migraines. Medicine. 2019; 98: 7. DOI: 10.1097/MD.0000000000014467.
Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NCND)
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Posted August 26, 2020.
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