Public Health

During a migraine attack, patients with migraine experience non-persistent cognitive impairment. However, some studies discuss migraine also as a risk factor for dementia in later life. The evidence, particularly with regard to mild cognitive impairment (MCI) as a precursor to dementia, is controversial. The aim of this study is to investigate the risk of incident MCI after five years in initially cognitively healthy participants with vs. without migraine.

2476 participants of the second (t1) and third (t2) examination of the prospective, population-based Heinz Nixdorf Recall Study (t1: 2005-2009, Ø62.9 years; t2: 2010-2015, Ø68.1 years) with complete data on migraine status (t1), cognitive performance (T1&T2) and age-appropriate cognition (t1) were included. MCI (at t2) was defined according to Winblad et al. (2004); migraine (at t1) was defined as self-reported diagnosis. Log-linear regression analyses with Poisson distribution were used to calculate the relative risk (RR) for incident MCI with 95% confidence interval (CI) for migraine vs. no migraine (unadjusted; adjusted for age, sex, education, alcohol consumption, smoking status, body mass index, depression according to directed acylic graph).

328 (13.2%) of the 2476 participants reported a migraine. Overall, 28 (8.5%) participants with migraine vs. 239 (11.1%) without migraine met the criteria for MCI at t2. There was no increased risk of incident MCI (unadjusted: RR 0.77, 95% CI 0.52-1.14; adjusted: RR 0.77, 95% CI 0.52-1.16) in participants with migraine.

Even though migraine attacks impair cognitive performance, our data show no longitudinal association between migraine and MCI as a precursor to dementia. In further analyses, a distinction should be made between migraine with and without aura.