Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy.
Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy.
Neurol Sci. 2024 Mar;45(3):1017-1030. doi: 10.1007/s10072-023-07069-0. Epub 2023 Sep 18.
In this systematic review and meta-analysis, we critically evaluate available evidence regarding the association between primary headaches and subsequent decline of cognitive function and dementia.
Recent studies suggested that headache disorders may increase the risk for dementia. However, available studies are conflicting.
To identify qualifying studies, we searched scientific databases, including Pubmed, Scopus, Web of Science, Science Direct and BMC, screening for relevant papers. In order to reduce the heterogeneity between different studies, the analyses were further subdivided according to the clinical diagnoses and the study methodologies.
We identified 23 studies investigating the association between primary headaches and the risk of dementia. Of these, 18 met our inclusion criteria for meta-analysis (covering 924.140 individuals). Overall effect-size shows that primary headaches were associated with a small increase in dementia risk (OR = 1,15; CI 95%: 1,03-1,28; p = 0,02). Analyzing subgroups, we found that migraine was associated with both a moderate increased risk of all-cause dementia (OR = 1,26; p = 0,00; 95% CI: 1,13-1,40) as well as a moderate increased risk of Alzheimer's disease (OR = 2,00; p = 0,00; 95% CI: 1,46-2,75). This association was significant in both case-control and retrospective cohort studies but not in prospective studies.
Our study supports the presence of a link between primary headaches and dementia. However, in the subgroup analysis, only patients with migraine showed a moderate increase risk for all-cause dementia and for Alzheimer's disease. Additional rigorous studies are needed to elucidate the possible role of primary headaches on the risk of developing cognitive impairment and dementia.
在本系统评价和荟萃分析中，我们批判性地评估了原发性头痛与认知功能下降和痴呆后续发展之间关联的现有证据。
最近的研究表明，头痛障碍可能会增加痴呆的风险。然而，现有研究存在矛盾。
为了确定合格的研究，我们搜索了科学数据库，包括 Pubmed、Scopus、Web of Science、Science Direct 和 BMC，筛选相关论文。为了减少不同研究之间的异质性，分析根据临床诊断和研究方法进一步细分。
我们确定了 23 项研究原发性头痛与痴呆风险之间的关联。其中，18 项符合我们的荟萃分析纳入标准（涵盖 924.140 人）。总体效应大小表明原发性头痛与痴呆风险略有增加相关（OR=1.15；95%CI：1.03-1.28；p=0.02）。分析亚组时，我们发现偏头痛与所有原因痴呆的中度风险增加（OR=1.26；p=0.00；95%CI：1.13-1.40）以及阿尔茨海默病的中度风险增加（OR=2.00；p=0.00；95%CI：1.46-2.75）相关。这种关联在病例对照和回顾性队列研究中均显著，但在前瞻性研究中不显著。
我们的研究支持原发性头痛与痴呆之间存在联系。然而，在亚组分析中，只有偏头痛患者的全因痴呆和阿尔茨海默病风险中度增加。需要进一步进行严格的研究，以阐明原发性头痛在认知障碍和痴呆风险中的可能作用。
