Abstract
BACKGROUND AND PURPOSE: There is evidence that migraine is a risk factor forstroke but little is known about this association in elderly people. Furthermore,non-migrainous headache (NMH) has received little attention despite being themost frequently reported type of headache. Late-life migraine and NMH wereexamined as candidate risk factors for stroke in a community-dwelling elderlysample over a 12-year follow-up.METHODS: One thousand nine hundred and nineteen non-institutionalized subjectsaged 65+, without dementia (Diagnostic and Statistical Manual of MentalDisorders, 4th edition, DSM-IV criteria) and with no stroke history at baseline, were drawn from the Three-City Montpellier cohort (recruitment 1999-2001) forlongitudinal analysis. Ischaemic and haemorrhagic stroke was reported at baselineand at each of the five follow-ups, with cases validated by a panel of experts,according to ICD-10 criteria (International Classification of Diseases, 10threvision). Migraine and NMH were determined at baseline during a neurologicalinterview 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 wereidentified at baseline. During the median 8.8-year follow-up, incident stroke wasobserved in 1.9% of baseline migrainers, 6.2% of NMH and 3.6% of those with nolifetime history of headache. Cox proportional hazard models indicated thatmigraine was not a risk factor for stroke; however, NMH sufferers were twice aslikely 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 particularlylow.