Islamoska S, Hansen J M, Hansen Å M, Garde A H, Waldemar G, Nabe-Nielsen K
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
Danish Headache Center, Rigshospitalet - Glostrup, Valdemar Hansens Vej 5, 2600 Glostrup, Denmark.
Public Health. 2022 Dec;213:54-60. doi: 10.1016/j.puhe.2022.09.018. Epub 2022 Nov 6.
Migraine and dementia, two major public health challenges, are associated, but more knowledge is needed to understand their relationship. Objectives of this study were to investigate 1) the association between non-self-reported measures of migraine and dementia, and whether dementia was associated with 2) migraine without aura (MO) and with aura (MA) in combination with migraine medication use, and 3) migraine severity operationalized as the number of migraine prescriptions.
Matched cohort study.
National register data were obtained from individuals born between 1934 and 1958. Migraine cases (aged 25-58 years) were identified by migraine diagnoses and redeemed migraine medication. Migraine cases were matched with non-cases (N = 340,850) and date of diagnosis or medication redemption was defined as index year. Dementia was identified by dementia diagnoses and redeemed dementia medication.
We observed a 1.46 (95% CI: 1.26-1.69) times higher dementia rate in individuals with a migraine diagnosis and a 0.86 (95% CI: 0.76-0.97) times lower rate when using migraine medication. We found the highest dementia rate among individuals with MA, who also used migraine medication (HR = 2.23; 95% CI: 1.19-4.17), and the lowest rate among individuals with MO, who also used medication (HR = 1.25; 95% CI: 0.75-2.10). The number of migraine medication prescriptions was not associated with dementia.
Being registered with a migraine diagnosis was associated with a higher dementia rate, while use of prescribed migraine medication was not. The differences in the dementia rate among migraine cases identified via diagnoses versus medications warrants further investigation.
偏头痛和痴呆是两大公共卫生挑战，二者存在关联，但仍需更多知识来理解它们之间的关系。本研究的目的是调查：1）偏头痛的非自我报告测量指标与痴呆之间的关联，以及痴呆是否与2）无先兆偏头痛（MO）和有先兆偏头痛（MA）以及偏头痛药物使用情况有关，3）将偏头痛严重程度定义为偏头痛处方数量。
匹配队列研究。
从1934年至1958年出生的个体中获取国家登记数据。通过偏头痛诊断和已兑现的偏头痛药物来确定偏头痛病例（年龄在25至58岁之间）。将偏头痛病例与非病例（N = 340,850）进行匹配，并将诊断日期或药物兑现日期定义为索引年。通过痴呆诊断和已兑现的痴呆药物来确定痴呆。
我们观察到，有偏头痛诊断的个体患痴呆的比率高出1.46倍（95%置信区间：1.26 - 1.69），而使用偏头痛药物时患痴呆的比率低0.86倍（95%置信区间：0.76 - 0.97）。我们发现，使用偏头痛药物的有先兆偏头痛患者患痴呆的比率最高（风险比 = 2.23；95%置信区间：1.19 - 4.17），而使用药物的无先兆偏头痛患者患痴呆的比率最低（风险比 = 1.25；95%置信区间：0.75 - 2.10）。偏头痛药物处方数量与痴呆无关。
登记有偏头痛诊断与较高的痴呆比率相关，而使用处方偏头痛药物则不然。通过诊断与药物确定的偏头痛病例中痴呆比率的差异值得进一步研究。
