Migraine With Aura Linked to High Risk of Dementia in Later Life

Jakob M. Hansen, MD, PhD, MSc

Results of a population-based cohort study suggest that migraine is indeed a mid-life risk factor for the development of dementia later in life, with a particularly increased risk observed in those with migraine with aura.¹

The study, led by Jakob M. Hansen, MD, PhD, MSc, of the Danish Headache Center in Denmark, sought to confirm results from previous studies that reported associations between migraine and dementia risk. Results were presented at the 2020 American Headache Society Virtual Annual Scientific Meeting on June 13, 2020.

Using national registry data from 1988 to 2017, Hansen and colleagues matched individuals 1:5 with migraine before age 59 (n = 18,135) to those without migraine (n = 1,378,346). Ultimately, 62,578 (median age, 49; 70% women) were incorporated in the analysis and followed for dementia (defined as dementia diagnosis or redeemed anti-dementia medication) from age 60 on.

Over a median follow-up of 6.9 years. 207 individuals with migraine were diagnosed with dementia. Compared with those without migraine, dementia occurrence was 50% greater in those with migraine (hazard ratio 1.50; 95% CI, 1.28-1.76). Notably, the hazard ratio decreased in those without aura (HR 1.19; 95% CI, 0.84-1.70) and was increased to 2.11 in those with aura (95% CI, 1.48-3.00).

The findings add to a growing body of evidence that shows a strong correlation between migraine and dementia. An analysis of community-dwelling older adults published in 2019² found that migraines were significantly associated with both all-cause dementia and Alzheimer disease, even after adjusting for several variables including age, gender, education, hypertension, stroke, diabetes, and more. Notably, no significant association between migraine and vascular dementia was observed in this cohort despite the vascular mechanisms associated with migraine pathophysiology.

Notably, that study included mostly women; similar to Hansen and colleagues’ analysis, and no men with a history of migraine included in that study were diagnosed with dementia.

“Our findings open new avenues for the understanding of pathological mechanisms underlying dementia and indicate the need for studies on potential dementia prevention by proper prophylactic treatment of migraine,” the Hansen and colleagues concluded.

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REFERENCES

1. Hansen J, Islamoska S, Hansen A, et al. Migraine as a risk factor for dementia: a national register-based follow-up study. Headache. 2020;60(S1 suppl):1-156. doi: 10.1111/head.13854

2. 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. Int J Geriatr Psychiatry. 2019;34(11):1667-1676. doi: 10.1002/gps.5180