Migraines do not exist in a vacuum. It is well known that migraines can lead to other co-morbidities; some more serious than others. A higher rate of dementia amongst migraineurs has recently been discovered, from a population-based longitudinal study in Denmark.
The study shows that migraineurs who received a hospital diagnosis between the ages of 31 to 58 (midlife) had a 50 percent higher rate of developing Dementia (after 60) than those who did not suffer migraines.
Migraines, of course, are not a homogenous condition. There are many sub-types; this variation in migraines has differing rates of subsequent dementia diagnosis, according to this study. Compared with non-migraineurs, those suffering migraines with aura were twice as likely to suffer with Dementia. This rate was reduced in those suffering migraines without aura, with the increased Dementia rate being 20 percent. The researchers also noted a correlation between increased rates of hospitalisation for migraine and subsequent Dementia diagnosis
The Study
Dr Sabrina Islamoska, PhD, of the University of Copenhagen and her team looked at the Danish national register to gather data on individuals who turned 60 before 2017, collating information on 65,578 people. This information was organised and cross-referenced with patients who had been admitted into hospital with migraines, against those who had not. The final variable against which all this data was filtered was Dementia diagnosis over the age of 60.
Analysis
Dr Islamoska stated that the results of the study ‘show that migraine is a risk factor for dementia, especially migraine with aura’. She hypothesized that this information ‘adds to previous studies supporting stronger vascular mechanisms in migraine with aura’
Dementia is a debilitating degenerative disease, with poor prognosis and treatment options. Identifying any risk factors which increase the chance of developing the disease is important in crafting preventative plans of action to limit one’s chance of developing dementia.
Dr Islamoska believes there are a number of ‘potential pathways’ which may underpin the connection between migraines and dementia. Migraines are a complex web, with a number of converging biological pathways involved, such as: allostatic load, the cardiovascular system, the cerebrovascular system, the neurological system, metabolic diseases as well as environmental factors. Dr Islamoska believes ‘these may lead to brain atrophy, changes in brain networks, lesions and neurodegeneration….these may increase the risk of dementia’
Suzanna Tyas, PhD of University of Waterloo, Canada, is also interested in the link between migraines and dementia. Dr Tyas led her own study, localised in her home country, looking for links between the two diseases. She found those with a medical history of migraines were three times more likely to develop Dementia and four times more likely to develop Alzheimer’s disease (a sub-type of Dementia). Dr Tyas believes it may be a good idea to ‘screen earlier for signs of cognitive decline in people with a history of migraines’. As there is now a clear link between the two diseases, it may be prudent to ‘treat more aggressively other risk factors for dementia and Alzheimers disease’ for those who suffer with migraines, to help reduce their risk of developing the disease.
Study limitations
There were various limiting factors to this study that the reader should be aware of:
- 60 percent of dementia cases go undiagnosed by clinicians.
- The study population was relatively young.
- The diagnosis of migraines in hospital may not correspond accurately to the onset of the disease in patients; they may have lived with the condition for years before their first hospital admission.
- Those patients who would have had diagnosed migraines in hospital would possibly be a more severe type than normal migraines, as migraines are usually diagnosed by primary care physicians.
Lead researcher’s final thoughts
Dr Islamoska calls for future studies to investigate the patho-physiology between migraines and dementia. She believes that if effort is put into the further study of this specific aspect of migraines, it is possible researchers will be able to ‘identify preventive measures and examine whether proper prophylactic treatment of migraine can prevent dementia’. The Doctor is currently looking for possible links between the efficacy of migraine medication and later risks of dementia.