title: Are migraine and non-migrainous headache risk factors for stroke in the elderly? Findings from a 12-year cohort follow-up.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Inserm U1061, Montpellier, France.|University of Montpellier, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Norton
authors.affiliation: Inserm U1061, Montpellier, France.|University of Montpellier, Montpellier, France.
authors.forename: F
authors.initials: F
authors.lastname: Portet
authors.affiliation: University of Montpellier, Montpellier, France.|Neurology Department, Memory Resources Research Center, University Hospital Gui de Chauliac, Montpellier, France.|Inserm U1183, Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Gabelle
authors.affiliation: Inserm U897, Bordeaux, France.|University of Bordeaux, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Debette
authors.affiliation: Inserm U1061, Montpellier, France.|University of Montpellier, Montpellier, France.|Faculty of Medicine, Imperial College, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Inserm U1061, Montpellier, France.|University of Montpellier, Montpellier, France.|Neurology Department, Memory Resources Research Center, University Hospital Gui de Chauliac, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Touchon
authors.affiliation: Inserm U1061, Montpellier, France.|University of Montpellier, Montpellier, France.|Neurology Department, Memory Resources Research Center, University Hospital Gui de Chauliac, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Berr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D020773:Headache Disorders / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000209:etiology*
keywords: cohort studies; elderly; migraine; non-migrainous headaches; risk factors; stroke