P3‐148: Does a history of migraines increase the risk of Alzheimer's disease or vascular dementia?

Dementia is the most co mmon neurological disease in older adults, while headaches are the most common neurological disorder across all ages. Migraines are a common form of headache disorders that affect millions of people worldwide. Both neurological disorders—dementia and migraines—cause significant impairment for the individual, as well as substantial economic impact on society. The relationship between migraines and dementia, including Alzheimer's disease (AD) and vascular dementia (VaD), has not yet been thoroughly explored. Analyses were based on 716 participants 65+ years from the Manitoba Study of Health and Aging in Canada. Participants screened cognitively intact at baseline, had complete data on migraine history and all covariates at baseline, and were assessed for cognitive outcomes five years later according to standard diagnostic criteria (dementia: DSM-IV; AD: NINCDS-ADRDA; VaD: NINDS-AIREN). The exposure (history of migraines), confounding (age, sex, education, depression) and intervening (hypertension, diabetes, stroke, myocardial infarction and other heart conditions) variables were based on self-report, and their association with dementia, AD and VaD was assessed using multiple logistic regression models. Individuals with a history of migraines were almost three times more likely (odds ratio [OR]=2.97; 95% CI=1.25–6.61) to develop dementia and approximately four times more likely (OR=4.22; 95% CI: 1.59–10.42) to develop AD compared to those without a history of migraines. A history of migraines was not significantly associated with VaD either before (OR=1.83; 95% CI: 0.39–8.52) or after (OR=1.52; 95% CI: 0.20–7.23) adjustment for confounding and intervening variables. Migraines are a significant risk factor for AD. In this study, the relationship between migraines and overall dementia was apparently driven by the strong relationship between migraines and AD. Despite the vascular mechanisms involved in migraine biology, a history of migraines was not a significant risk factor for VaD. Recognition of the long-term detrimental consequences of migraines for AD has implications for the importance of migraine prevention and management as well as for our understanding of AD etiology.