Health Behaviors and Social Determinants of Migraine in a Canadian Population-Based Sample of Adults Aged 45-85 Years: Findings From the CLSA

Abstract

Background: Social determinants of health are well linked to adverse health outcomes, but less is known about how they relate to migraine. While much attention has been given to the role of modifiable lifestyle factors which may mitigate risk of migraine, the role of physical activity in headache management is not yet understood.

Objectives: The purpose of this study was to explore the relationship between social determinants of health, health behaviors, and migraine prevalence in a sample of the Canadian population aged 45-85 years.

Methods: In this cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging, respondents were between 45 and 85 years of age and migraine was self-report of physician diagnosis. Analyses were stratified by sex/gender (n_women = 22,176, n_men = 21,549).

Results: The weighted prevalence of migraine for men and women was 7.5% and 19.6%, respectively. There were relationships between social determinants of health and migraine for both men and women. Notably, higher perceived social status was associated with a 3% reduced odds of migraine among women (OR = 0.97, 95% CI: 0.95, 0.98, P < .001). Gay and bisexual men had 50% higher odds of migraine compared to heterosexual men (OR = 1.50, 95% CI: 1.13, 1.99, P = .005). Some forms of physical activity were associated with reduced odds of migraine for women: walking for 30 minutes but less than 1 hour (OR = 0.87, 95% CI: 0.78, 0.96, P = .005), light sports for less than 30 minutes (OR = 0.86, 95% CI: 0.73, 1.00, P = .048), and 1 hour but less than 2 hours (OR = 0.85, 95% CI: 0.74, 0.97, P = .018), strenuous sports for 30 minutes but less than 1 hour (OR = 0.79, 95% CI: 0.71, 0.89, P < .001), and 1 hour but less than 2 hours (OR = 0.82, 95% CI: 0.73, 0.92, P = .001). Men who engaged in daily walking as a form of leisure time physical activity had higher odds of migraine: walking less than 30 minutes (OR = 1.21, 95% CI: 1.01, 1.45, P = .042), 2 hours but less than 4 hours (OR = 1.42, 95% CI: 1.11, 1.80, P = .005), and 4 hours or more (OR = 1.65, 95% CI: 1.18, 2.31, P = .004).

Conclusions: Social determinants of health are associated with migraine prevalence for both men and women. Physical activity is a modifiable lifestyle factor which merits further exploration as an intervention option for migraine headaches in aging samples, especially among older women. Greater odds of migraine among older men who walked for exercise may be explained by reverse causality.

Keywords: Canadian Longitudinal Study on Aging; aging; migraine; physical activity; social determinants.