Study Finds No Association Between Migraine, Cognitive Decline

Although older individuals with migraine have more cognitive complaints, migraine and non-migraine headache are not associated with increased risk of dementia or cognitive decline at an older age, according to a study published in The Journal of Headache and Pain.

To determine whether migraine and other headaches modify the rate of decline of cognitive measures, researchers assessed 275 study participants over the age of 50. Individuals with migraine (MH), non-migraine headaches (NMH), and controls without headache (WoH) completed initial tests of memory, language, and executive functions, and were reevaluated 5 years later.

Cognitive symptoms such as impairments in executive functions, memory, and learning are common among migraineurs.

In this prospective longitudinal observational study, 12.7% of participants experienced MH, 8.7% experienced NMH, and 78.5% were controls. The majority of the cohort were females (64%) and researchers found “cognitive decline or dementia occurred in 11.4%, with a similar proportion among the three groups.” At baseline, the average age of study participants was 70 years.

In addition, the study showed MH participants had significantly more subjective cognitive complaints (P = .030; 95% CI: —3.929,–0.014), when compared with NMH and WoH. However, both MH and NMH participants exhibited age-associated decline identical to controls. Migraine features such as attack frequency, duration, and presence of aura were unrelated to cognitive performance. The results suggest repeated migraine attacks do not have a long-term impact on cognition.

Licensed neuropsychologists carried out neuropsychological evaluations, which included a series of tests on episodic memory, semantic memory, attention/processing speed, executive functions, and language skills. Individual scores were then converted to age and education-adjusted z-scores. Researchers also calculated an executive and memory function composite score. If individuals scored below —1.5 on any of the composite scores, they were classified as cognitively impaired or having dementia (if they also had impaired daily living activities).

“Migraine participants were more often female, younger, had more depressive symptoms and more subjective memory complaints than WoH subjects,” researchers said. They continued, “The number of subjective cognitive complaints was significantly different among headache groups, after controlling for age and depressive symptoms (P = .021), being higher at baseline and remaining high and stable with aging in MH as opposed to NMH subjects (mean diff. = − 2.037; P = .030; 95% CI: —3.929, −0.014) in whom they increased with age.”

Because they did not calculate the power or sample size necessary to obtain differences between groups, researchers note future high-powered and longer follow-up studies are warranted to draw more definitive conclusions.

“We did not find evidence for increased risk of cognitive decline or dementia or steeper cognitive decline, over a 5-year period, in subjects with migraine and non-migraine headaches, when compared to individuals without headache,” researchers concluded.

Reference:

Martins IP, Maruta C, Alves PN, et al. Cognitive aging in migraine sufferers is associated with more subjective complaints but similar age-related decline: a 5-year longitudinal study.

J Headache Pain. 2020; 21(1):31. Doi: 10.1186/s10194-020-01100-x.