Mid- to late-life migraine diagnoses and risk of dementia: a national register-based follow-up study.
Dementia
Headache
Migraine
Neurology
Journal
The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562
Informations de publication
Date de publication:
06 Aug 2020
06 Aug 2020
Historique:
received:
09
07
2020
accepted:
23
07
2020
entrez:
9
8
2020
pubmed:
9
8
2020
medline:
21
10
2020
Statut:
epublish
Résumé
Previous studies found an association between migraine and dementia, which are two leading causes of disability. However, these studies did not differentiate between migraine types and did not investigate all prevalent dementia subtypes. The main objective of this national register-based study was to investigate whether migraine was a risk factor for dementia. Additionally, we explored potential differences in dementia risk for migraine with and without aura. We obtained data on birth cohorts born between 1935 and 1956 (n = 1,657,890) from Danish national registers. Individuals registered with migraine before age 59 (n = 18,135) were matched (1:5) on sex and birthdate with individuals without migraine (n = 1,378,346). Migraine was defined by International Classification of Diseases (ICD) diagnoses and dementia was defined by ICD diagnoses and anti-dementia medication. After matching, 62,578 individuals were eligible for analysis. For the statistical analyses, we used Cox regression models and adjusted for socio-demographic factors and several psychiatric and somatic morbidities. During a median follow-up time of 6.9 (IQR: 3.6-11.2) years, 207 individuals with migraine developed dementia. Compared with individuals without migraine, we found a 50% higher rate of dementia among individuals with migraine (HR = 1.50; 95% CI: 1.28-1.76). Individuals without aura had a 19% higher rate of dementia (HR = 1.19; 95% CI: 0.84-1.70), and individuals with aura had a two times higher rate of dementia (HR = 2.11; 95% CI: 1.48-3.00). Our findings support the hypothesis that migraine is a midlife risk factor for dementia in later life. The higher rate of dementia in individuals with a hospital-based diagnosis of migraine with aura emphasizes the need for studies on pathological mechanisms and potential preventative measures. Furthermore, given that only hospital-based migraine diagnoses were included in this study, future research should also investigate migraine cases derived from the primary healthcare system to include less severe migraine cases.
Sections du résumé
BACKGROUND
BACKGROUND
Previous studies found an association between migraine and dementia, which are two leading causes of disability. However, these studies did not differentiate between migraine types and did not investigate all prevalent dementia subtypes. The main objective of this national register-based study was to investigate whether migraine was a risk factor for dementia. Additionally, we explored potential differences in dementia risk for migraine with and without aura.
METHODS
METHODS
We obtained data on birth cohorts born between 1935 and 1956 (n = 1,657,890) from Danish national registers. Individuals registered with migraine before age 59 (n = 18,135) were matched (1:5) on sex and birthdate with individuals without migraine (n = 1,378,346). Migraine was defined by International Classification of Diseases (ICD) diagnoses and dementia was defined by ICD diagnoses and anti-dementia medication. After matching, 62,578 individuals were eligible for analysis. For the statistical analyses, we used Cox regression models and adjusted for socio-demographic factors and several psychiatric and somatic morbidities.
RESULTS
RESULTS
During a median follow-up time of 6.9 (IQR: 3.6-11.2) years, 207 individuals with migraine developed dementia. Compared with individuals without migraine, we found a 50% higher rate of dementia among individuals with migraine (HR = 1.50; 95% CI: 1.28-1.76). Individuals without aura had a 19% higher rate of dementia (HR = 1.19; 95% CI: 0.84-1.70), and individuals with aura had a two times higher rate of dementia (HR = 2.11; 95% CI: 1.48-3.00).
CONCLUSIONS
CONCLUSIONS
Our findings support the hypothesis that migraine is a midlife risk factor for dementia in later life. The higher rate of dementia in individuals with a hospital-based diagnosis of migraine with aura emphasizes the need for studies on pathological mechanisms and potential preventative measures. Furthermore, given that only hospital-based migraine diagnoses were included in this study, future research should also investigate migraine cases derived from the primary healthcare system to include less severe migraine cases.
Identifiants
pubmed: 32762715
doi: 10.1186/s10194-020-01166-7
pii: 10.1186/s10194-020-01166-7
pmc: PMC7410151
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
98Subventions
Organisme : Velux Fonden
ID : 00014847
Références
Cephalalgia. 2018 Jan;38(1):1-211
pubmed: 29368949
Cephalalgia. 2015 Feb;35(2):118-31
pubmed: 25246519
Neurology. 2006 Oct 10;67(7):1128-34
pubmed: 17030745
Cephalalgia. 2014 Apr;34(5):327-35
pubmed: 24265286
Lancet. 2018 Mar 31;391(10127):1315-1330
pubmed: 29523342
Dement Geriatr Cogn Disord. 2007;24(3):220-8
pubmed: 17690555
Front Cell Neurosci. 2018 Aug 03;12:233
pubmed: 30127722
Int J Geriatr Psychiatry. 2011 Nov;26(11):1128-35
pubmed: 21194100
Scand J Public Health. 2011 Jul;39(7 Suppl):91-4
pubmed: 21775362
Scand J Public Health. 2011 Jul;39(7 Suppl):30-3
pubmed: 21775347
J Headache Pain. 2015;16:89
pubmed: 26471177
Scand J Public Health. 2011 Jul;39(7 Suppl):26-9
pubmed: 21775346
BMJ Open. 2018 Mar 27;8(3):e020498
pubmed: 29593023
Medicine (Baltimore). 2019 Feb;98(7):e14467
pubmed: 30762763
Int J Geriatr Psychiatry. 2019 Nov;34(11):1667-1676
pubmed: 31486140
Pract Neurol. 2014 Feb;14(1):23-31
pubmed: 24453269
Acta Neurol Scand. 2019 May;139(5):405-414
pubmed: 30710346
Headache. 2013 Apr;53(4):589-98
pubmed: 23405909
Lancet. 2017 Sep 16;390(10100):1211-1259
pubmed: 28919117
J Headache Pain. 2018 Nov 15;19(1):109
pubmed: 30442090
Alzheimers Dement (N Y). 2015 Jul 26;1(2):122-130
pubmed: 29854932
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
J Headache Pain. 2019 Sep 6;20(1):96
pubmed: 31492106
Front Aging Neurosci. 2018 Mar 28;10:83
pubmed: 29643804
Neurology. 2013 Oct 1;81(14):1260-8
pubmed: 23986301
Cochrane Database Syst Rev. 2012 Feb 15;(2):CD006378
pubmed: 22336816
Neurology. 2004 Feb 24;62(4):563-8
pubmed: 14981171
Ugeskr Laeger. 2014 Nov 24;176(48):
pubmed: 25430573
Neurotherapeutics. 2018 Apr;15(2):361-370
pubmed: 29508147
Lancet. 2017 Dec 16;390(10113):2673-2734
pubmed: 28735855
Neuroepidemiology. 2013;41(3-4):139-45
pubmed: 23921376
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
pubmed: 21775352
Neurotherapeutics. 2018 Apr;15(2):274-290
pubmed: 29235068
J Alzheimers Dis. 2019;71(1):353-360
pubmed: 31403950
Dement Geriatr Cogn Disord. 2012;34(5-6):292-9
pubmed: 23208125
Cephalalgia. 1988;8 Suppl 7:1-96
pubmed: 3048700
J Cereb Blood Flow Metab. 2016 Jan;36(1):172-86
pubmed: 26174330
Scand J Public Health. 2011 Jul;39(7 Suppl):38-41
pubmed: 21775349
Arq Neuropsiquiatr. 2020 Mar;78(3):133-138
pubmed: 32236328
J Clin Epidemiol. 2004 Dec;57(12):1288-94
pubmed: 15617955
J Headache Pain. 2018 Oct 11;19(1):95
pubmed: 30306350