Association Between Migraine and Frailty Among Middle-Aged and Older Adults: A Cross-Sectional Study Based on CHARLS

Frailty represents a geriatric syndrome characterized by diminished physiological reserves and increased vulnerability to adverse health outcomes. While chronic diseases are established frailty risk factors, the relationship between migraine-a prevalent neurological condition affecting millions globally-and frailty development remains unexplored, representing a critical knowledge gap in geriatric neurology.

We conducted a cross-sectional analysis using baseline data (2011-2015) from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative cohort. Frailty was assessed using a validated 32-item Frailty Index based on deficit accumulation theory. Multivariable logistic regression models examined migraine-frailty associations, with sequential adjustment for sociodemographic factors, lifestyle behaviors, and comorbid conditions. Subgroup analyses evaluated effect modification across key demographic and clinical variables.

Among 13,798 participants (mean age 57.6 ± 9.1 years; 49.6% female), 598 (4.3%) reported migraine and 1,315 (9.5%) met frailty criteria. Migraine participants demonstrated a 4.5-fold higher frailty prevalence (37.0% vs. 8.3%, p < 0.001) and significantly elevated median frailty scores (20.0 vs. 7.8, p < 0.001). A multivariable analysis revealed a robust independent association (OR = 5.61, 95% CI: 4.51-6.99, p < 0.001). Smoking status significantly modified this relationship (P-interaction = 0.025), with the strongest associations in ever-smokers (OR = 8.78, 95% CI: 4.36-17.69) and current smokers (OR = 7.30, 95% CI: 4.87-10.96).

This study establishes migraine as a novel independent risk factor for frailty in Chinese middle-aged and older adults. The pronounced smoking interaction suggests targeted tobacco cessation interventions may benefit frailty prevention in migraine patients.