Are migraine and non-migrainous headache risk factors for stroke in the elderly? Findings from a 12-year cohort follow-up
Abstract
BACKGROUND AND PURPOSE: There is evidence that migraine is a risk factor for
stroke but little is known about this association in elderly people. Furthermore,
non-migrainous headache (NMH) has received little attention despite being the
most frequently reported type of headache. Late-life migraine and NMH were
examined as candidate risk factors for stroke in a community-dwelling elderly
sample over a 12-year follow-up.
METHODS: One thousand nine hundred and nineteen non-institutionalized subjects
aged 65+, without dementia (Diagnostic and Statistical Manual of Mental
Disorders, 4th edition, DSM-IV criteria) and with no stroke history at baseline,
were drawn from the Three-City Montpellier cohort (recruitment 1999-2001) for
longitudinal analysis. Ischaemic and haemorrhagic stroke was reported at baseline
and at each of the five follow-ups, with cases validated by a panel of experts,
according to ICD-10 criteria (International Classification of Diseases, 10th
revision). Migraine and NMH were determined at baseline during a neurological
interview and examination using 1988 International Headache Society criteria.
RESULTS: A total of 110 (5.4%) cases of migraine and 179 (8.9%) cases of NMH were
identified at baseline. During the median 8.8-year follow-up, incident stroke was
observed in 1.9% of baseline migrainers, 6.2% of NMH and 3.6% of those with no
lifetime history of headache. Cox proportional hazard models indicated that
migraine was not a risk factor for stroke; however, NMH sufferers were twice as
likely to have a stroke (hazard ratio 2.00, 95% confidence interval 1.00-3.93, P
= 0.049).
CONCLUSIONS: This study is one of the first to suggest that late-life NMH rather
than migraine could be an independent risk factor for stroke and a warning sign.
The incidence of stroke in elderly migrainers, seldom reported, is particularly
low.
Origin : Files produced by the author(s)
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