Acupuncture Treatment is Associated with Reduced Dementia Risk in Patients with Migraine: A Propensity-Score–Matched Cohort Study of Real-World Data

Abstract

Background

Migraine is a recurrent headache disease that has been identified as a risk factor for subsequent dementia. 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 or did not concurrently receive acupuncture treatment.

Methods

A 1:1 propensity score method was used to match an equal number of patients (N = 4813) 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.

Results

Patients with migraine who received acupuncture treatment were found to have a lower risk of dementia (adjusted hazard ratio [aHR] = 0.51, 95% CI = 0.40–0.65) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the nonacupuncture cohort (Log rank test, p < 0.001). This propensity score–matched cohort study demonstrated an association between acupuncture treatment and dementia development in patients with migraine in Taiwan.

Conclusion

The results suggest that acupuncture treatment significantly reduced the development of dementia in patients with migraine.

Keywords:

• acupuncture
• migraine
• dementia
• National Health Insurance Research Database
• NHIRD
• propensity score
• cohort

Data Sharing Statement

Data are available from the National Health Insurance Research Database (NHIRD), published by the Taiwan National Health Insurance (NHI) Bureau. The use of the NHIRD is limited to research purposes only. Due to the legal restrictions imposed by the government of Taiwan in relation to the Personal Information Protection Act, the data used for this study cannot be made publicly available. Request for data can be sent as a formal proposal to the NHIRD (http://nhird.nhri.org.tw).

Acknowledgments

This study was conducted using data from the NHIRD, which was provided by the National Health Insurance Administration and the Ministry of Health and Welfare, and supervised by the National Health Research Institutes. We would like to thank the management of the office for health data of China Medical University Hospital for collecting and analyzing the data used in this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This study was supported in part by China Medical University Hospital (DMR-107-008; DMR-110-222), Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), Taiwan Ministry of Science and Technology (MOST) Clinical Trial Consortium for Stroke (MOST 109-2321-B-039-002), and the Tseng-Lien Lin Foundation in Taichung, Taiwan. The study was also financially supported by the Chinese Medicine Research Center of China Medical University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education in Taiwan (CMRC-CENTER-0). The funders did not participate in carrying out the study.