Migraine, Cognitive Decline, and Dementia in Older Adults: A Population-Based Study

Article type: Research Article

Authors: Liang, Yajun^{a; b; 1} | Gao, Ya^{c; 1} | Wang, Rui^{a; d} | Grande, Giulia^a | Monastero, Roberto^e | Dong, Yanhong^c | Jiang, Xin^c | Lv, Peiyuan^{c; *} | Qiu, Chengxuan^{a; *}

Affiliations: [a] Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden | [b] Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden | [c] Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China | [d] Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden | [e] Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy

Correspondence: [*] Corresponding authors: Dr Chengxuan Qiu, Aging Research Center, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, S-171 65 Solna, Sweden. Tel.: +46 8 52485821; E-mail: chengxuan.qiu@ki.se and Prof Peiyuan Lv, Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang 050051, Hebei, China. E-mail: peiyuanlu@163.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:The potential impact of migraine on cognitive aging among older adults remains controversial. Objective:To examine the relationship of migraine and subtypes with cognitive decline and dementia in an older Swedish population. Methods:This population-based study included 3,069 participants (age ≥ 60 years) from the Swedish National study on Aging and Care in Kungsholmen, Stockholm. Baseline examination was conducted in 2001–2004, and participants were followed every 3 or 6 years until 2013–2016. Data were collected through face-to-face interviews, clinical examinations, laboratory tests, and linkage with registers. Global cognitive function was measured with the Mini-Mental State Examination (MMSE). Dementia was diagnosed according to the DSM-IV criteria. Migraine and subtypes were defined following the international classification system. Data were analyzed using logistic regression, Cox regression, and linear mixed-effects models. Results:At baseline, 305 participants were defined with non-migraine headache and 352 with migraine. The cross-sectional analysis showed that the multivariable-adjusted odds ratio (95% confidence interval) of prevalent dementia was 0.49 (0.20–1.21) for migraine and 0.66 (0.26–1.66) for migraine without aura. The longitudinal analysis showed that the multivariable-adjusted hazard ratios of incident dementia associated with migraine and subtypes ranged 0.68–0.89 (p > 0.05). Furthermore, migraine and subtypes were not significantly associated with either baseline MMSE score or MMSE changes during follow-ups (p > 0.05). The nonsignificant associations did not vary substantially by age, APOE ɛ4 allele, cerebrovascular disease, and antimigraine treatment (p for interactions > 0.05). Conclusion:This study shows no evidence supporting the associations of migraine and its subtypes with cognitive decline and dementia among older adults.

Keywords: Cognitive aging, dementia, headache, migraine, population-based study

DOI: 10.3233/JAD-220013

Journal: Journal of Alzheimer's Disease, vol. 88, no. 1, pp. 263-271, 2022