Increased risk of all-cause, Alzheimer’s, and vascular dementia in adults with migraine in Korea: a population-based cohort study

Abstract

Background Studies investigating the association between migraine and dementia have reported inconsistent findings. This study aimed to evaluate whether patients with migraine have an increased risk of dementia compared to individuals without migraine. Methods We obtained data from the 2002–2019 Korean National Health Insurance Health Screening Cohort. Non-migraine controls were selected using a 1:1 risk-set matching with a time-dependent propensity score. The main outcome was the development of all-cause dementia, and the secondary outcome was the development of each cause of dementia (Alzheimer’s, vascular, mixed or other specified, and unspecified dementia). The incidence rate of dementia was calculated using Poisson regression, and the association between migraine and dementia was evaluated using Cox proportional hazards regression. Results Among 88,390 participants, 66.1% were female, and the mean baseline age was 55.3 ± 9.4 years. During the study period, dementia cases were identified in 4,800 of the 44,195 patients with migraine and 3,757 of the 44,915 matched controls. The incidence rate of dementia was 139.6 (95% confidence interval [CI], 135.7–143.5) and 107.7 (95% CI, 104.3–111.1) cases per 10,000 person-years in patients with migraine and matched controls, respectively. Patients with migraine had a 1.30 (hazard ratio [HR], 1.30; 95% CI, 1.25–1.35), 1.29 (HR, 1.29; 95% CI, 1.23–1.35), 1.35 (HR, 1.35; 95% CI, 1.19–1.54), 1.36 (HR, 1.36; 95% CI, 1.00–1.83), and 1.30 (HR, 1.30; 95% CI, 1.17–1.45) times higher risk of developing all-cause dementia, Alzheimer’s dementia, vascular dementia, mixed or other specified dementias, and unspecified dementia than their matched controls, respectively. Conclusion Our results suggest that migraine is associated with an increased risk of subsequent dementia. Further research is warranted to confirm these findings and to reveal the underlying mechanisms.

Association between chronic pain and dementia: a systematic review and meta-analysis

“…However, due to the nature of cross-sectional study design, it is difficult to determine whether dementia was caused by other factors or if it influenced the perception of pain (Wang et al 2022 ). Furthermore, a majority of the studies included in our analysis indicated that the risk of dementia increased as the age of individuals with chronic pain advanced (Wang and Liu 2021 ; Khalid et al 2022 , 2020 ; Innes and Sambamoorthi 2020 ; Whitlock et al 2017 ; Rouch et al 2022 ; Tzeng et al 2018 ; Cheng et al 2022 ; Kao et al 2021 ; Hurh et al 2022 ; Morton et al 2019 ; Hagen et al 2014 ; Islamoska et al 2020 ; George et al 2020 ; Lee et al 2019 ; Kostov et al 2019 ; Chen et al 2018 ; Huang et al 2015 ). This suggests that older age may be a contributing factor to the development of dementia in individuals with chronic pain.…”

“…Among the included studies, one was cross-sectional (Wang et al 2022 ) and two were case–control designs (Lee et al 2019 ; Chen et al 2018 ), while the remaining 16 studies were cohort studies. Eighteen studies examined the risk of developing dementia after a diagnosis of chronic pain (Wang and Liu 2021 ; Khalid et al 2022 , 2020 ; Innes and Sambamoorthi 2020 ; Whitlock et al 2017 ; Rouch et al 2022 ; Tzeng et al 2018 ; Cheng et al 2022 ; Kao et al 2021 ; Hurh et al 2022 ; Morton et al 2019 ; Hagen et al 2014 ; Islamoska et al 2020 ; George et al 2020 ; Lee et al 2019 ; Kostov et al 2019 ; Chen et al 2018 ; Huang et al 2015 ), and one study explored the comorbidity of dementia in patients with chronic pain (Wang et al 2022 ).…”

“…There is growing evidence indicating that the health consequences of pain are associated with the onset and progression of dementia (Whitlock et al 2017 ; Belin and Gatt 2006 ; Wang et al 2022 ; Wang and Liu 2021 ; Khalid et al 2022 , 2020 ; Innes and Sambamoorthi 2020 ; Whitlock et al 2017 Aug 1b ; Rouch et al 2022 ; Tzeng et al 2018 ; Cheng et al 2022 ; Kao et al 2021 ; Hurh et al 2022 ; Morton et al 2019 ; Hagen et al 2014 ; Islamoska et al 2020 ; George et al 2020 ; Lee et al 2019 ; Kostov et al 2019 ; Chen et al 2018 ; Huang et al 2015 ), which is a critical issue. Neurodegenerative diseases, such as Alzheimer’s disease and related dementias, are increasingly prevalent worldwide due to the rapid aging of the global population.…”

Is headache a risk factor for dementia? A systematic review and meta-analysis

“…To evaluate the risk of Alzheimer’s Disease in patients with primary headache we performed a meta-analysis considering only studies reporting data about patients with Alzheimer’s Disease. We included seven studies [ 27 , 28 , 31 , 33 , 38 , 44 , 45 ] in the statistical analysis. We calculated pooled effect size (forest plot figure 1 supplementary materials) and results showed that headache was associated with increased of risk of Alzheimer’s disease (OR = 2,07; p = 0,00; 95% CI: 1,57–2,72).…”

Thirty Risk Factors for Alzheimer’s Disease Unified by a Common Neuroimmune–Neuroinflammation Mechanism

“…In a nationwide (South Korea) cohort study, Kim et al showed that the overall incidence of AD was greater in people with a chronic migraine history than in non-migraineurs (8.0 per 1000 person-years vs. 4.1 per 1000 person-years) [101]. Similarly, in a populationbased cohort study involving 88,390 participants, Hurh et al concluded that migraine is associated with an increased risk of subsequent AD [102]. Multiple other epidemiological studies support the observation that migraine is a risk factor for AD [103,104].…”