Migraine is associated with better cognition in the middle-aged and elderly: the Rotterdam Study

Converging evidence suggests that migraine has, in part, a vascular basis. In turn, vascular pathology is a strong risk factor for cognitive decline. In this population-based study, we studied cognition amongst individuals with and without migraine.

In 6708 participants of the Rotterdam Study, migraine was assessed using a validated questionnaire. Cognition was assessed by the Mini Mental State Examination (MMSE) and a dedicated cognitive test battery. Participants were classified as non-migraineurs (n = 5399), migraineurs (n = 1021) or probable migraineurs (n = 288). Multivariable linear regression was used to cross-sectionally evaluate the association between migraine and cognition, adjusting for age, sex and cardiovascular risk factors. Additionally, we stratified the analysis by sex and by migraine subtype.

Migraineurs had higher mean MMSE scores [unstandardized regression coefficient 0.21, (95% confidence interval, 0.08; 0.34)] and global cognition [0.10 (0.04; 0.15)] than non-migraineurs. This difference was particularly marked for migraineurs with aura [MMSE: 0.39 (0.13; 0.66); global cognition: 0.13 (0.01; 0.24)]. Migraineurs performed better on tests of executive function and fine motor skills amongst specific cognitive domains. The difference in MMSE between migraineurs and non-migraineurs was greater in women [0.25 (0.10; 0.40)] than in men [0.13 (-0.15; 0.40)], whereas the difference in global cognition was similar in men and women [0.15 (0.04; 0.27) and 0.09 (0.02; 0.15), respectively].

Migraineurs, particularly migraineurs with aura, tend to score higher in cognition tests than non-migraineurs. More studies are needed to corroborate these findings.