Migraine and Dementia: Are They Linked?

A history of migraines was a significant risk factor for Alzheimer disease (AD) and all‐cause dementia, but not vascular dementia, in a recent study examining older adults living independently. Dementia is the most common neurological disease in older adults, and identifying predictors of dementia is critical, researchers noted, given the current increases in prevalence and expected further growth as the population ages. Headaches, including migraines, are the most common neurological disorder across all ages; previous studies have found some suggestions of an association between migraine and dementia. However, the associations are poorly defined and may vary by dementia subtype, headache/migraine measure, gender, comorbidities, and clinical versus community‐based samples.

Finding a midlife risk factor for dementia—such as migraine—could allow for earlier detection of at‐risk patients. A better understanding of a possible relationship could include earlier screening for cognitive decline in patients with migraine, as well as interventions to delay dementia, to improve the quality of life, and to increase the likelihood of healthy aging. Patients with a history of migraines were 3 and 4 times more likely to be diagnosed later with both all‐cause dementia (odds ratio [OR], 2.97; 95% CI, 1.25‐6.61) and AD (OR, 4.22; 95% CI, 1.59‐10.42), even after adjustment for confounding and intervening variables.

However, migraines were not significantly associated with vascular dementia either before (OR, 1.83; 95% CI, 0.39‐8.52) or after (OR, 1.52; 95% CI, 0.20‐7.23) such adjustment, despite vascular involvement in migraines. At follow‐up 5 years later, 7.5% (n = 51) of participants had developed dementia, 5.1% (n = 34) had developed AD, and 1.9% (n = 12) had developed vascular dementia. However, no men reporting a history of migraines were diagnosed with dementia.

Those with dementia, AD, or vascular dementia were significantly older; those with dementia or AD had significantly less education. Stroke was significantly more common in participants with dementia or vascular dementia than in those whose cognition was unaffected. Although stroke was not an independent statistically significant predictor of dementia, it met statistical criteria to be included in the fully adjusted model.