Acupuncture Treatment to Reduce the Risk of Dementia in Patients With Migraine: A Propensity Score–Matched Cohort Study

BackgroundMigraine is a recurrent headache disease that has been identified as a risk factor for subsequent dementia. In Taiwan, some patients with migraine receive acupuncture treatment for other illnesses. Therefore, the association between the effects of acupuncture treatment and the risk of dementia in patients with migraine warrants investigation. The present study collected data from Taiwan’s National Health Insurance Research Database (NHIRD) to investigate the incidence of dementia in patients with migraine who did and did not concurrently receive acupuncture treatment.MethodsWe conducted a retrospective matched-cohort study that included 37,266 patients, selected from the NHIRD, who were newly diagnosed with migraine at some time between 2000 and 2012. The follow-up period ranged from the index date (the date when patients first received acupuncture after their migraine diagnosis) to dementia diagnosis, withdrawal from the insurance program, or December 31, 2013. A 1:1 propensity score method was used to match an equal number of patients (N = 11,280) in the acupuncture and nonacupuncture cohorts based on sex, age, migraine diagnosis year, index year, insurance amount, urbanization level, baseline comorbidities, and medication usage. We employed Cox proportional hazards models to evaluate the risk of dementia. The cumulative incidence of dementia in both cohorts was estimated using the Kaplan–Meier method, and the difference was assessed through a log-rank test.ResultsPatients with migraine who received acupuncture treatment were found to have a lower risk of dementia (adjusted hazard ratio [aHR] = 0.48, 95% CI = 0.40–0.57) than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, urbanization level, baseline comorbidities, and medication usage. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the nonacupuncture cohort (log-rank test, p < 0.001).ConclusionsThis propensity score–matched cohort study demonstrated an association between acupuncture treatment and dementia development in patients with migraine in Taiwan. The results suggest that acupuncture treatment significantly reduced the development of dementia in patients with migraine. However, future study is required to provide more empirical evidence.