Association between migraine and Alzheimer's disease: a nationwide cohort study

Jaeho Kim; Woo Seok Ha; Sang Hyun Park; Kyungdo Han; Min Seok Baek

doi:10.3389/fnagi.2023.1196185

Association between migraine and Alzheimer's disease: a nationwide cohort study

Front Aging Neurosci. 2023 May 25:15:1196185. doi: 10.3389/fnagi.2023.1196185. eCollection 2023.

Authors

Jaeho Kim¹, Woo Seok Ha^{2

3}, Sang Hyun Park⁴, Kyungdo Han⁴, Min Seok Baek^{5

6}

Affiliations

¹ Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si, Republic of Korea.
² Department of Neurology, Gangwon-do Wonju Medical Center, Wonju, Republic of Korea.
³ Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
⁵ Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
⁶ Research Institute of Metabolism and Inflammation, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Abstract

Background and objective: Migraine is a common chronic neurological disease characterized by pulsating headaches, photophobia, phonophobia, nausea, and vomiting. The prevalence of dementia in individuals aged over 65 years in Korea is more than 10%, and Alzheimer's disease (AD) dementia accounts for most cases. Although these two neurological diseases account for a large portion of the medical burden in Korea, few studies have examined the relationship between the two diseases. Therefore, this study investigated the incidence and risk of AD in patients with migraines.

Methods: We retrospectively collected nationwide data from a national health insurance claims database governed by Korea's National Health Insurance Service. Among Koreans in the 2009 record, patients with migraine were identified according to the International Classification of Diseases, 10th revision (ICD-10) code G43. First, we screened the database for participants aged over 40 years. Individuals diagnosed with migraine at least twice over more than 3 months in a year were considered to have chronic migraine in this study. Further, all participants with an AD diagnosis (ICD-10 code: Alzheimer's disease F00, G30) were investigated for AD dementia development. The primary endpoint was AD development.

Results: The overall incidence of AD dementia was higher in individuals with a history of migraine than in those with no migraine history (8.0 per 1,000 person-years vs. 4.1 per 1,000 person-years). The risk of AD dementia was higher in individuals diagnosed with migraine (hazard ratio = 1.37 [95% confidence interval, 1.35-1.39]) than in the control group after adjustments for age and sex. Individuals with chronic migraine had a higher incidence of AD dementia than those with episodic migraine. Younger age (<65 years old) was associated with an increased risk of AD dementia compared to older age (≥65 years old). Higher body mass index (BMI) (≥25 kg/m²) was also associated with an increased risk of AD dementia compared to lower BMI (<25 kg/m²) (p < 0.001).

Conclusion: Our results suggest that individuals with a migraine history are more susceptible to AD than those without a migraine history. Additionally, these associations were more significant in younger and obese individuals with migraine than in individuals without migraine.

Keywords: Alzheimer’s disease; cohort studies; dementia; headache; migraine.