Migraine as a Risk Factor for Dementia: A National Register-based Follow-up Study

Sabrina Islamoska, PhD

AHSAM 2020 - Oral session
Published on October 2, 2020 | NEW

4 minute

Key messages

  • Dementia is the century’s greatest global challenge for health and social care.
  • Migraine is a midlife risk factor for dementia in later life, particularly migraine with aura.
  • Greater understanding on how the mechanisms of migraine pathways can increase the risk of dementia are needed to improve prevention and treatment.

Key messages

  • Dementia is the century’s greatest global challenge for health and social care.
  • Migraine is a midlife risk factor for dementia in later life, particularly migraine with aura.
  • Greater understanding on how the mechanisms of migraine pathways can increase the risk of dementia are needed to improve prevention and treatment.

Background

What do we already know about this topic?

  • Migraine and dementia are the most prevalent neurological disorders and leading causes of disability in the world.
  • Life expectancy is increasing worldwide, and consequently, so are age-related diseases such as dementia, representing a challenge for health and social care. 1,2,3,4,5
  • Previous studies have reported an association between migraine and dementia risk, but they have not differentiated between migraine with or without aura, and have been limited to subtypes of dementia. 6–13

How was this study conducted?

  • A Danish population-based longitudinal cohort study (N=62,578) using national register data on individuals born 1935–1956 diagnosed with migraine midlife (31–58 years) between 1988–2017.
  • Individuals registered with migraine before turning 59 years old (n=18,135) were matched (1:5) on sex and birthdate with individuals without migraine (n=1,378,346).
  • Outcome measures were dementia diagnosis or redemption of dementia medications after the age of 60.

Findings

What does this study add?

  • The median age at migraine diagnosis was 49 years old and 70% of the cohort were women.
  • Compared with individuals without migraine, there was a 50% higher rate of dementia among individuals with any migraine diagnosis.
  • The dementia rate was twice as high in migraine with aura than without aura.
  • Dementia rate was higher with more frequent hospital contact for individuals with migraine compared with individuals without migraine.

Perspectives

How does this study impact clinical practice?

  • Migraine could be a midlife risk factor for dementia in later life, and therefore, it is important that migraine patients are monitored.
  • The findings emphasize the need for studies on migraine-dementia pathophysiology, particularly in migraine with aura.
  • Possible mechanisms linking migraine to dementia include allostatic load, cardio-, cerebrovascular- and metabolic diseases as well as behavioral factors. These mechanisms can lead to brain atrophy, changes in brain networks, lesions and neurodegeneration, which in the long term cause dementia.
  • The effects of migraine medications on dementia risk needs to be investigated to assess the impact of mild/moderate migraines.

This is a highlights summary of an oral session given at the AHSAM 2020 Virtual Annual Scientific Meeting and presented by:

Sabrina Islamoska, PhD
Postdoc Researcher University of Copenhagen
Copenhagen, Hovedstaden, Denmark Slides

The content is produced by Infomedica, the official reporting partner of ASHAM 2020 Virtual Annual Scientific Meeting. The summary text was drafted by Goldcrest Medical Writing, reviewed by Marco Vercellino, MD, an independent external expert, and approved by Jessica Ailani, MD, FAHS and Mark J. Burish, MD, PhD, the scientific editors of the program.

The presenting authors of the original session had no part in the creation of this conference highlights summary.

1. Taudorf L, Nørgaard A, Islamoska S, et al. Declining incidence of dementia: A national registry-based study over 20 years. Alzheimer’s & Dementia 2019;15:1383-1391.

2. Wimo A, Guerchet M, Ali GC, et al. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimer’s & Dementia 2017;13:1-7.

3. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1211-1259.

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6. Stovner Nichols, Steiner et al. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology 2018;17:954-976.

7. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38:1-211.

8. Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience Biobehavioral Reviews 2010;35:2-16.

9. Borsook D, Maleki N, Becerra L, et al. Understanding migraine through the lens of maladaptive stress responses: a model disease of allostatic load. Neuron 2012;73:219-234.

10. Bashir A, Lipton RB, Ashina S, et al. Migraine and structural changes in the brain: a systematic review and meta-analysis. Neurology 2013;81:1260-1268.

11. Wang, J., Xu, W., Sun, S. et al. Headache disorder and the risk of dementia: a systematic review and meta-analysis of cohort studies. J Headache Pain 2018;19:95.

12. Escher CM, Sannemann L, Jessen F. Stress and Alzheimer's disease. Journal of Neural Transmission 2019;126:1155-1161.

13. Ouanes S, Popp J. High Cortisol and the Risk of Dementia and Alzheimer's Disease: A Review of the Literature. Frontiers in Aging Neuroscience 2019;11:43.

Headache
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