Age-specific and gender-dependent impact of primary headache disorders on dementia risk

Abstract

Dementia is a global burden of public health. Headache disorders are the third most common cause of disability worldwide and common problems in the elderly population. Few studies focused on the relationship between primary headache disorders (PHDs) and cognitive status, and the results remain controversial. The aim of this countrywide, population-based, retrospective study was to investigate potential association between PHDs and dementia risk.We enrolled 1346 cases with PHDs to match the 5384 individuals by age, gender and co-morbidities. The definition of PHDs, dementia, and risk factors of dementia was identified according to The International Classification of Diseases, Ninth Revision, Clinical Modification. Cox regression was administered for estimating hazard ratios (HR) for dementia.During more than 5 years of follow-up, PHDs individuals had 1.52 times (P <.05) greater risk to develop all dementia compared with individuals without PHDs. Elderly (aged ≥65 years) patients with PHDs displayed significantly higher risk to develop all dementia (P <.01) and non-Alzheimer non-vascular dementia (NAVD) P <.01). Female PHDs individuals were at higher risk of suffering from all dementia (P <.05) and NAVD (P <.05). The influence of PHDs on all dementia was highest in the first 2 years of observation.The results indicated PHDs are linked to a temporarily increased risk for dementia, mainly NAVD, with age-specific and gender-dependent characteristics.

Migraine and the risk of all‐cause dementia, Alzheimer's disease, and vascular dementia: A prospective cohort study in community‐dwelling older adults

“…Additional evidence supports an association of dementia with headaches overall (including migraines) and nonmigrainous headaches . However, the association between migraines and dementia was significant only among women in models stratified by gender: this same gender effect was observed for all headaches and nonmigrainous headaches . The present study reflected this strong association of migraines with dementia in women; it was unable to assess potential gender differences because no male participants had dementia as well as a history of migraines.…”

“…The significant increased risk of dementia with migraines noted in this study is consistent with those of other cohort studies 9,11,13 and in contrast with other individual studies 12 and a meta-analysis of cohort studies 7 that found no association. Additional evidence supports an association of dementia with headaches overall (including 12,13 However, the association between migraines and dementia was significant only among women in models stratified by gender 9 : this same gender effect was observed for all headaches 25 and nonmigrainous headaches. 13 The present study reflected this strong association of migraines with dementia in women; it was unable to assess potential gender differences because no male participants had dementia as well as a history of migraines.…”

“…While significant associations between various definitions of headaches/migraines and dementia subtypes other than VaD and AD were found across a series of studies based on a health insurance database in Taiwan, interpretation of this subtype is unclear. In one study, this other dementia category excluded AD and VaD yet contributed almost all of the dementia cases. Other studies using the same database defined their other dementia subtype based simply on exclusion of VaD and did not classify it further by AD.…”

“…Other studies using the same database defined their other dementia subtype based simply on exclusion of VaD and did not classify it further by AD. However, based on results from Yin et al, this dementia category would similarly be expected to be predominantly non‐AD dementia, raising issues of generalizability to other populations where AD would be a more common contributor to the prevalence of dementia.…”

“…Thus, in addition to the influences of gender, dementia subtype, and headache/migraine measure, differences in results may reflect the different sources used to recruit subjects. Unlike the current study, other studies have included patient populations, either directly or through health insurance databases . Patient populations would disproportionately include those with more severe migraines, as they would be more likely to seek medical attention for management of their migraines.…”