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

Background 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. Methods 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. Results 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). Conclusion 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.