Midlife Migraines Tied to Higher Dementia Risk, 40-Year Study Suggests

A large study spanning more than 40 years suggested that migraines in midlife were associated with a modest increase in the long-term risk of dementia.

Adults with migraines in midlife were slightly more likely to experience dementia later in life compared with those without migraine (HR 1.07, 95% CI 1.02-1.13), reported Pamela Rist, PhD, of Brigham and Women’s Hospital in Boston, and colleagues in a poster session at the American Academy of Neurology annual meeting.

“Prior studies have mainly examined the association between late-life migraine and dementia,” Rist noted. “This study adds to the body of evidence by suggesting that midlife migraine may also be associated with an increased risk of dementia,” she told MedPage Today.

“Future research is needed to understand the pathways by which midlife migraine influences late-life dementia risk to determine possible prevention strategies,” Rist added.

Earlier studies have reported mixed results about how migraine and dementia risk might be connected. National register data in Denmark in 2020, for example, showed that adults who had migraine with aura had a high risk of dementia, but the relationship was not significant for migraineurs without aura. In the Atherosclerosis Risk in Communities neurocognitive study, however, there was no association between migraine and incident dementia, even though there was evidence of brain abnormalities in migraine patients.

More recently, a systematic review and meta-analysis of 11 studies spanning nearly 7 million participants tied migraine to higher risks of all-cause dementia, Alzheimer’s disease, and vascular dementia. Earlier research led by Rist also tied migraine with aura to cardiovascular risk prediction.

In the current analysis, Rist and colleagues linked survey questionnaire data collected during voluntary multiphase health check-ups in a cohort of patients from 1964 to 1972 to Kaiser Permanente electronic medical records (EMRs) beginning in 1996. The study sample included patients born from 1919 to 1936.

The questionnaires asked patients whether they had experienced frequent severe headaches in the past 6 months and about the features associated with those headaches. In 1972 and 1973, patients were asked directly whether they had ever been diagnosed with migraine.

Migraine was defined as a “yes” response to any migraine-related question. Dementia cases were identified using ICD-9 and ICD-10 codes in EMRs starting in 1997.

A total of 34,364 individuals were included in the study; of these, 8,339 people (24.3%) were classified as having migraine in midlife, with an average age of 40 years at migraine assessment. Overall, 28% of the cohort developed dementia, with a mean age of 84 at dementia diagnosis.

More work is needed to further understand possible relationships between migraine and dementia, the researchers noted. “Further studies are needed to adjust for potential confounders from early to midlife, and to determine how the onset of other health conditions, such as stroke or high blood pressure, may modify these associations,” they wrote.

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