TOPLINE:

Migraine was associated with a 30% reduced risk for all-cause dementia and a 42% reduced risk for Alzheimer’s disease (AD) compared with not having migraine in a new cohort study.

METHODOLOGY:

• Investigators assessed data for more than 6800 participants (mean age, 66 years; 57% female) in the Rotterdam Study, a prospective population-based cohort in Netherlands that began in 1990.
• At baseline, 15% of participants had migraine, which was determined through questionnaires administered in homes or via telephone interviews conducted between 2006 and 2011.
• Participants were screened for dementia at baseline at subsequent visits using the Mini-Mental State Examination and Geriatric Mental Schedule, with diagnoses confirmed through in-person assessments, medical record linkage, and neuroimaging when available.
• Follow-up extended until the diagnosis of incident dementia, death, the last known dementia-free date, or January 1, 2020, whichever occurred first. The median follow-up duration was 9.4 years.

TAKEAWAY:

• Participants with migraine had a lower risk for both all-cause dementia (hazard ratio [HR], 0.70; 95% CI, 0.51-0.95) and AD (HR, 0.58; 95% CI, 0.40-0.85) than those without migraine.
• During follow-up, 491 participants developed dementia (incidence rate, 7.9 per 1000 person-years at risk), of whom 379 (77%) had AD.
• Consistent protective effects of migraine were observed in women (HR, 0.69 for dementia; HR, 0.55 for AD) but did not reach statistical significance in men.

IN PRACTICE:

“These results challenge the traditional risk factor hypothesis and suggest a potential neuroprotective role” for migraine, the investigators of the study wrote.

“Whether this reflects biological neuroprotection or methodological factors is currently unclear, necessitating further investigation,” they added.

SOURCE:

The study was led by Cevdet Acarsoy, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands. It was published online on April 23 in Alzheimer’s & Dementia.

LIMITATIONS:

The criteria used in the study screened only those participants who had severe painful headaches, excluding milder cases. Although the cohort was prospective, migraine status was sometimes assessed retrospectively through lifetime symptom questions, risking recall bias. Detailed data on migraine medications and dosages were lacking, and only a subset of participants reported use of medications, limiting assessment of whether medication explained the apparent protective effect. Additionally, a short follow-up period yielded few dementia events and precluded meaningful stratified analyses.

DISCLOSURES:

The study was funded by several organizations, including Erasmus Medical Center and Erasmus University Rotterdam, the Netherlands Organization for Scientific Research, the Netherlands Organisation for Health Research and Development, and the Research Institute for Diseases in the Elderly. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.