Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
J Alzheimers Dis. 2022;88(1):263-271. doi: 10.3233/JAD-220013.
The potential impact of migraine on cognitive aging among older adults remains controversial.
To examine the relationship of migraine and subtypes with cognitive decline and dementia in an older Swedish population.
This population-based study included 3,069 participants (age ≥ 60 years) from the Swedish National study on Aging and Care in Kungsholmen, Stockholm. Baseline examination was conducted in 2001-2004, and participants were followed every 3 or 6 years until 2013-2016. Data were collected through face-to-face interviews, clinical examinations, laboratory tests, and linkage with registers. Global cognitive function was measured with the Mini-Mental State Examination (MMSE). Dementia was diagnosed according to the DSM-IV criteria. Migraine and subtypes were defined following the international classification system. Data were analyzed using logistic regression, Cox regression, and linear mixed-effects models.
At baseline, 305 participants were defined with non-migraine headache and 352 with migraine. The cross-sectional analysis showed that the multivariable-adjusted odds ratio (95% confidence interval) of prevalent dementia was 0.49 (0.20-1.21) for migraine and 0.66 (0.26-1.66) for migraine without aura. The longitudinal analysis showed that the multivariable-adjusted hazard ratios of incident dementia associated with migraine and subtypes ranged 0.68-0.89 (p > 0.05). Furthermore, migraine and subtypes were not significantly associated with either baseline MMSE score or MMSE changes during follow-ups (p > 0.05). The nonsignificant associations did not vary substantially by age, APOEɛ4 allele, cerebrovascular disease, and antimigraine treatment (p for interactions > 0.05).
This study shows no evidence supporting the associations of migraine and its subtypes with cognitive decline and dementia among older adults.
偏头痛对老年人认知老化的潜在影响仍存在争议。
在瑞典老年人群中，研究偏头痛及其亚型与认知能力下降和痴呆的关系。
本研究为基于人群的研究，纳入了来自斯德哥尔摩 Kungsholmen 的瑞典老龄化与护理国家研究中的 3069 名参与者（年龄≥60 岁）。基线检查于 2001-2004 年进行，参与者每 3 或 6 年随访一次，直至 2013-2016 年。数据通过面对面访谈、临床检查、实验室检查和与登记处的链接收集。使用简易精神状态检查（MMSE）测量总体认知功能。根据 DSM-IV 标准诊断痴呆。偏头痛及其亚型按照国际分类系统定义。使用逻辑回归、Cox 回归和线性混合效应模型进行数据分析。
基线时，305 名参与者被诊断为非偏头痛性头痛，352 名参与者被诊断为偏头痛。横断面分析显示，调整多变量后，偏头痛和无先兆偏头痛的现患痴呆的比值比（95%置信区间）分别为 0.49（0.20-1.21）和 0.66（0.26-1.66）。纵向分析显示，偏头痛和亚型与新发痴呆的多变量调整风险比在 0.68-0.89 之间（p＞0.05）。此外，偏头痛和亚型与基线 MMSE 评分或随访期间 MMSE 变化均无显著相关性（p＞0.05）。交互作用检验的 p 值均＞0.05，表明这些关联在年龄、载脂蛋白 Eɛ4 等位基因、脑血管疾病和偏头痛治疗等亚组之间无显著差异。
本研究没有证据支持偏头痛及其亚型与老年人认知能力下降和痴呆之间存在关联。
