1. CERAD immediate memory verbal fluency (animals)
Migraine and Cognitive Function: baseline Findings From the Brazilian Longitudinal Study of Adult Health - ELSABrasil
Cristina Pellegrino Baena, Alessandra Carvalho Goulart, Paulo Andrade Lotufo, Itamar de Souza Santos, Isabela Martins Benseñor
Universidade de Sao Paulo USP; Pontificia Universidade Católica do Paraná PUCPR
BACKGROUND
Migraine and dementia are associated with higher vascular risk and both conditions have been linked with structural brain lesions
Evidence on the possible association between migraine and cognitive performance is unclear.
AIM
To analyze whether migraine is associated with cognitive performance within the Brazilian Longitudinal Study of Adult Health, ELSA-Brasil.
METHODS
Cross-sectional analysis
All participants without previous stroke, who were not taking medications that could impair cognitive performance and with complete data on cognitive tests or migraine at baseline assessment were analyzed
Migraine based on International Headache Society classification was used as dependent variable in binary logistic models
The Consortium to Establish a Registry for Alzheimer’s disease scores for word list memory test (CERAD-WLMT), the semantic fluency test (SFT), and the Trail Making Test version B (TMTB) were categorized into poor cognitive performance as defined by a score below mean minus one standard deviation for a participant’s sex, age and educational-level group for memory and fluency tests and as a score above mean plus one standard deviation for the time to perform the Trail Making Test Version B
Multivariate analyses were adjusted for marital status, alcohol consumption, smoking, physical activity, body-mass index, hypertension, diabetes mellitus and depression.
In women we further adjusted for hormone replacement therapy.
RESULTS
4993 men(51.6 ±9.2 y) and 5028 women (51.9±8.9y ) were analyzed
131 men( 2.6 %) and 926 women (18.4%) migraneurs
Proportion of participants in the poor cognitive category did not differ significantly between migraneurs and non-migraneurs for men or women in any of the cognitive tests (p>0.072 for all)
Table 1 - Characteristics of the studied population (n=10023; men=4993; women n = 5030)  
Men (n=4993)
Women n=(5030)
p-value
Non-migraineurs
Migraineurs
n= 4862
n=131
n=4104
n=926
Age (sd)
51.73 (9.3)
48.4 (6.6)
p<0.001
52.81 (9.0)
48.1 (7.3)
Race (%)
0.289
0.127
White
2695 (56.2)
63 (49.2)
2230 (54.9)
481 (52.2)
Brown
1371 (28.6)
40 (31.3)
1018 (25.1)
242 (26.2)
Black
596 (12.4)
19 (14.8)
645 (15.9)
170 (18.4)
Educational level (%)
0.056
High school
1615 (33.2)
58 (44.3)
1323 (32.3)
379 (40.9)
College or higher
2750 (56.6)
61 (46.6)
2543 (62)
498 (53.8)
Marital status (%)
0.100
0.001
Married
2991 (61.5)
81 (61.8)
1555 (37.9)
384 (41.5)
Not married, but live with other
964 (19.8)
23 (17.6)
553 (13.5)
155 (16.7)
BMI kg/m2 (sd)
27.05 (4.26)
25.95 (4.27)
0.004
26.90 (5.12)
26.72 (5.01)
0.323
Smoking status (%)
0.620
0.333
Never
2500 (51.4)
73 (55.7)
2568 (62.6)
583 (63)
Former
1696 (34.9)
42 (32.1)
1083 (26.4)
228 (24.6)
Current
666 (13.7)
16 (12.2)
453 (11)
115 (12.4)
Alcohol use (%)
203 (4.2)
11 (8.4)
580 (14.1)
144 (15.6)
780 (16)
38 (29)
715 (17.4)
211 (22.8)
3878 (79.8)
82 (62.6)
2805 (68.4)
571 (61.7)
Physical activity (%)
0.299
Weak
3418 (71.3)
99 (77.3)
3115 (77.1)
749 (82.6)
Moderate
789 (16.5)
18 (14.1)
566 (14)
101 (11.1)
Vigorous
585 (12.2)
11 (8.6)
359 (8.9)
57 (6.3)
Depression (%)
76 (1.6)
7 (5.3)
0.006
125 (3)
83 (9)
High blood pressure (%)
1889 (38.9)
31 (23.7)
1290 (31.4)
214 (23.1)
Diabetes mellitus (%)
1070 (22)
0.007
681 (16.6)
112 (12.1)
Dyslipidemia (%)
2879 (59.2)
176 (58)
0.376
2349 (57.3)
494 (53.3)
0.033
HRT$ (%)
436 (10.6)
69 (7.5)
0.537
Table 2- Odds ratio (95% confidence interval) of poor cognitive performance in migraineurs compared to non-migraineurs.
migraineurs versus non-migraineurs
CERAD immediate memory
CERAD recall memory
CERAD recognition
verbal fluency (animals)
Trail B making test
Men
Model 1
1.01 (0.61;1.67)
1.17 (0.72;1.91)
0.83 (0.51;1.36)
1.13 (0.68;1.90)
1.70 (0.93;3.10)
Model 2
1.00 (0.60;1.66)
1.11 (0.68;1.83)
0.84 (0.51;1.38)
1.13 (0.67;1.89)
1.72 (0.94;3.14)
Women
0.84 (0.69;1.01)
1.01 (0.84;1.22)
1.19 (0.96;1.46)
1.02 (0.83;1.26)
1.07 (0.87;1.32)
0.86 (0.70;1.05)
1.03 (0.85;1.24)
1.20 (0.97;1.48)
0.97 (0.78;1.20)
1.04 (0.85;1.29)
Model 3
0.85 (0.70;1.04)
1.02 (0.85;1.24)
1.19 (0.96;1.47)
0.97 (0.79;1.21)
1.05 (0.85;1.29)
Model 1 - age and education adjusted, Model 2 - plus marital status, alcohol consumption, smoking, physical activity, BMI, high blood pressure, diabetes mellitus and depression. Model 3 - plus hormonal replacement therapy
Figure 2 – Proportion (%) of participants in the poor performance category for each cognitive scores * by sex.
* Mean minus 1 SD for memory and fluency tests and mean plus 1SD for TMTB
CONCLUSION
Migraine is not associated with cognitive performance in middle-aged participants of the ELSA-study.
The authors have no disclosure to make.
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