Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
BMJ. 2012 Aug 8;345:e5027. doi: 10.1136/bmj.e5027.
To evaluate the association between migraine and cognitive decline among women.
Prospective cohort study.
Women's Health Study, United States.
6349 women aged 65 or older enrolled in the Women's Health Study who provided information about migraine status at baseline and participated in cognitive testing during follow-up. Participants were classified into four groups: no history of migraine, migraine with aura, migraine without aura, and past history of migraine (reports of migraine history but no migraine in the year prior to baseline).
Cognitive testing was carried out at two year intervals up to three times using the telephone interview for cognitive status, immediate and delayed recall trials of the east Boston memory test, delayed recall trial of the telephone interview for cognitive status 10 word list, and a category fluency test. All tests were combined into a global cognitive score, and tests assessing verbal memory were combined to create a verbal memory score.
Of the 6349 women, 853 (13.4%) reported any migraine; of these, 195 (22.9%) reported migraine with aura, 248 (29.1%) migraine without aura, and 410 (48.1%) a past history of migraine. Compared with women with no history of migraine, those who experienced migraine with or without aura or had a past history of migraine did not have significantly different rates of cognitive decline in any of the cognitive scores: values for the rate of change of the global cognitive score between baseline and the last observation ranged from -0.01 (SE 0.04) for past history of migraine to 0.08 (SE 0.04) for migraine with aura when compared with women without any history of migraine. Women who experienced migraine were also not at increased risk of substantial cognitive decline (worst 10% of the distribution of decline). When compared with women without a history of migraine, the relative risks for the global score ranged from 0.77 (95% confidence interval 0.46 to 1.28) for women with migraine without aura to 1.17 (0.84 to 1.63) for women with a past history of migraine.
In this prospective cohort of women, migraine status was not associated with faster rates of cognitive decline.
评估偏头痛与女性认知能力下降之间的关联。
前瞻性队列研究。
美国妇女健康研究。
参加妇女健康研究且年龄在 65 岁或以上的 6349 名女性，她们在基线时提供了偏头痛状况信息，并在随访期间接受了认知测试。参与者被分为四组：无偏头痛史、有先兆偏头痛、无先兆偏头痛和既往偏头痛史（有偏头痛病史报告但在基线前一年无偏头痛）。
采用电话认知状态访谈、东波士顿记忆测试即时和延迟回忆试验、电话认知状态 10 字列表延迟回忆试验和类别流畅性测试，每两年进行一次认知测试，最多进行三次。所有测试综合为一个总体认知评分，评估语言记忆的测试综合为一个语言记忆评分。
在 6349 名女性中，853 名（13.4%）报告有偏头痛；其中，195 名（22.9%）有先兆偏头痛，248 名（29.1%）无先兆偏头痛，410 名（48.1%）有既往偏头痛史。与无偏头痛史的女性相比，有或无先兆偏头痛或有既往偏头痛史的女性在任何认知评分中认知下降的速度均无显著差异：基线与最后一次观察之间总体认知评分变化率的数值范围为从既往偏头痛史的 0.01（SE 0.04）到有先兆偏头痛的 0.08（SE 0.04），与无任何偏头痛史的女性相比。有偏头痛史的女性也没有更高的认知能力大幅下降风险（下降分布最差的 10%）。与无偏头痛史的女性相比，全球评分的相对风险范围为无先兆偏头痛的 0.77（95%置信区间 0.46 至 1.28）到既往偏头痛史的 1.17（0.84 至 1.63）。
在这项前瞻性队列研究中，偏头痛状况与认知能力下降速度较快无关。
